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UNIVERSITY  OF  CALIFORNIA 

MEDICAL  CENTER  LIBRARY 

SAN  FRANCISCO 


HISTORY  COLLECTION 


PEDIATRICS 
OF  THE  PAST 


PEDIATRICS 

OF  THE  PAST 

AN  ANTHOLOGY  COMPILED  6?  EDITED  BY 

JOHN  RUHRAH,  M.D. 


PROFESSOR  OF  DISEASES  OF  CHILDREN, 
UNIVERSITY  OF  MARYLAND 


WITH  A  FOREWORD  BY 
FIELDING  H.  GARRISON,  M.D. 


WITH  FIFTY 'FOUR  TEXT  ILLUSTRATIONS  AND 
EIGHTEEN  FULL  PAGE  PLATES 


PAUL  B.  HOEBER,  Inc. 

NEW  YORK    »     MCMXXV 
3> 


>  >      ' 


Copyright,  1925 
By  PAUL  B.  HOEBER,  Inc. 


Published  June,  1925 


Printed  in  the  United  States  of  America 


«■      t     c 

■    «  I 


*  «     « 

•    *  « 


The  American  Medical  Profession 
owes  a  debt  of  gratitude 

To  Fielding  Hudson  Garrison 

LIEUTENANT'COLONEL,  MEDICAL  CORPS,  U.  S.  ARMY 

for  his  contributions  to  medical  history  and 
bibliography  and  for  the  generous  assistance 
he  has  always  given  students  of  these  subjects. 

This  volume  is  inscribed  to  him  as  an  ex* 
pression  of  the  appreciation  of  the  author. 


PREFACE 

THIS  work  has  been  a  labor  of  love  and  represents  the 
result  of  a  number  of  years,  the  spare  hours  of  which  were 
used  in  reading  the  works  of  the  early  writers,  in  looking 
up  their  lives  and  in  trying  to  estimate  their  influence  on  pedia- 
trics— a  delightful  task  that  has  been  thoroughly  enjoyed. 

When  one  enters  a  modern  American  hotel  and  is  handed 
the  menu  from  which  the  dinner  is  to  be  ordered,  the  eye  meets  a 
bewildering  array  of  dishes  designed  to  suit  all  tastes.  However 
wealthy,  however  hungry,  one  can  eat  only  a  certain  amount  at  one 
sitting.  Looking  about  the  dining  room  one  sees  a  wide  difference 
in  the  choice  of  food.  In  a  like  manner,  presented  with  the  list  of 
pediatric  writers,  which  will  be  found  at  the  end  of  this  volume  in 
the  excerpt  taken  from  Meissner's  "Grundlage,"  one  is  bewildered 
at  the  richness  of  the  feast  offered.  But  one  volume  will  hold  but 
so  much.  The  choice  which  has  been  made  by  the  editor  is  per- 
haps not  the  choice  which  another  would  have  made,  but  choose 
one  must,  and  where  no  other  criterion  offered,  personal  predilec- 
tions were  allowed  full  sway.  The  result  is  a  short  introduction 
from  the  writers  before  the  introduction  of  printing,  followed 
by  translations  done  into  English  for  the  first  time  of  the  pedi- 
atric incunabula.  Owing  to  their  inaccessibility  to  the  average 
reader  these  have  been  accorded  considerable  space.  There  follow 
selections  from  various  sources  which  are  apparent  on  consulting 
the  table  of  contents.  Some  rare  items  of  exceptional  interest 
are  reprinted  in  their  entirety,  others  are  merely  illustrated  by  a 
page  or  two.  Whytt's  treatise  shows  what  a  keen  observer  can  do 
with  a  limited  number  of  cases;  Heberden,  what  a  clear-headed 
physician  can  say  in  a  few  words,  and  so  on.  The  collection  prob- 
ably illustrates  the  progress  of  pediatrics  fairly  well  up  to  the 
beginning  of  the  nineteenth  century.  By  consulting  Meissner's 
"Grundlage"  the  omissions  are  evident. 

This  volume  will  supplement  the  admirable  "History  of 
Pediatrics"  by  Lieut.-Col.  F.  H.  Garrison.  Indeed  it  was  first 
planned  to  do  this  work  with  Lieut.-Col.  Garrison  but  his  many 

vii 


viii  PREFACE 

activities  in  other  lines  prevented.  To  him  the  writer  wishes  to 
express  due  appreciation  for  his  suggestions,  his  encouragement, 
his  help  in  ways  too  numerous  to  mention.  Thanks  are  also  due  to 
Prof.  Karl  Sudhoff  of  Leipsic,  unfailing  in  courtesy  and  helpfulness; 
to  Prof.  Hermann  CoIIitz  of  Baltimore,  for  his  translations  of  the 
old  German  poems;  to  Dr.  Herbert  F.  Wright  of  Washington,  for 
his  translation  of  the  early  Latin  works ;  to  Dr.  Albert  Allemann  of 
Washington,  for  the  translation  of  the  Oesterreicher  aphorisms; 
to  the  librarians  in  the  numerous  libraries  in  which  the  writer 
has  worked,  for  many  courtesies;  to  Mrs.  R.  M.  Winterling, 
his  former  secretary,  and  Miss  A.  H.  Long,  his  present  one,  for 
help  with  the  preparation  of  the  manuscript,  and  to  all  the  others 
too  numerous  to  mention  who  have  furthered  this  undertaking. 

John  Ruhrah 

Baltimore,  Md. 
April,  1925. 


o 


FOREWORD 

NE  of  the  most  striking  and,  at  the  same  time,  most 
natural  of  the  immediate  effects  of  the  invention  of  print- 
ing, was  the  appearance  of  huge  volumes  in  folio,  made 
up  of  collections  of  the  best  extant  writings  on  theology, 
philosophy  and  medicine.  The  tendency,  albeit  thrown  into  relief 
by  the  most  powerful  agent  of  civilization  ever  given  to  man,  was 
by  no  means  a  new  one.  It  rooted  in  the  remote  past  and  sprang 
from  one  of  the  fundamental  qualities  of  the  human  mind,  namely, 
its  collectivistic  tendency.  As  the  savage  and  the  primitive  collect 
beads,  pigments,  wampum,  amulets,  fetishes  and  other  objects 
which  represent  "values"  to  him,  so  each  and  every  one  of  us 
tends  to  assemble  around  him  the  books  and  objects  which  he 
likes  best  or  which  are  most  useful  to  him — the  tools  of  his  trade. 
As  we  grow  older,  each  of  us  would  like  to  have  a  special  collection 
of  the  poems,  pictures  and  music  we  like  best,  and  to  ignore  and 
exclude  the  rest.  Our  private  libraries,  could  we  but  manage  it, 
would  be  like  the  collection  of  Samuel  Pepys  as  described  by 
Lowell,  "of  almost  Himalayan  selectness."  Upon  entering  a  room, 
the  connoisseur  will  almost  inevitably  and  instinctively  be  drawn 
to  the  book  shelves,  the  etchings  and  engravings,  the  glass 
cabinets  of  bibelots,  bric-a-brac,  netsukes,  carved  ivory  or  porce- 
lain, or  appraise,  with  a  swift  glance,  the  Oriental  rugs  or  what  not. 
Indeed  the  brothers  Goncourt  go  so  far  as  to  say  that  a  person's 
taste  may  be  measured  by  what  he  surrounds  himself  with  (La 
distinction  des  choses  autour  d'un  etre  est  la  mesure  de  la  distinction 
de  cet  etre).  The  same  writers  have  said  elsewhere  that  "there 
are  collections  of  art  objects  which  display  neither  passion  nor 
taste  nor  intelligence,  but  only  the  brutal  victory  of  wealth." 
Now,  long  before  the  invention  of  printing,  indeed  as  far 
back  as  human  history  goes,  physicians  made  collections  of  the 
best  medical  texts  of  their  time,  one  of  the  first  symptoms  of 
intellectual  refinement  in  man,  yet,  in  this  case,  something  of 
more  utilitarian  and  practical  character  than  our  tendency  to 
collect   antique   furniture,   old   china,   lace,   postage   stamps   or 

ix 


x  FOREWORD 

posters.  Thus  the  sumptuous  format  of  the  Ebers  Papyrus,  with 
its  black  and  white  hieratic  script,  indicates  that  it  was  a  genuine 
edition  de  luxe,  as  if  prepared  for  some  great  temple;  while  the  fact 
that  it  is  written  in  several  dialects,  let  alone  the  nature  of  its 
contents,  shows  it  to  be  a  true  medical  anthology  of  the  time,  made 
up  of  different  treatises  or  of  extracts  from  the  best  writings 
extant.  In  like  manner,  the  whole  body  of  the  Hippocratic  writ- 
ings is,  in  the  technical  sense,  not  a  single  individualized  treatise, 
like  Celsus  or  Aretaeus,  but  a  scripture  or  canon,  like  the  Old 
Testament;  for  us,  indeed,  an  assemblage  of  the  very  best  medical 
thought  of  the  time.  So  too,  with  Oribasius,  with  Aetius,  with 
Paul,  and  the  other  Byzantine  medical  compilers,  and  so  also,  to 
some  extent,  with  Avicenna  and  with  many  of  the  larger  Arabic 
texts,  only  the  most  important  of  which  have  been  printed.  In  the 
earlier  Middle  Ages,  it  was  the  ambition  of  the  literary  physician 
to  write  a  summa  medicinalis,  a  huge  tome  summarizing  all  the 
medical  knowledge  of  his  time.  Many  of  the  medical  incunabula, 
the  books  printed  before  1500,  are  gigantic  compilations  of  this 
character,  either  an  assemblage  of  various  medical  writings 
or  a  sort  of  hodgepodge,  giving  the  gist  of  such  writings.  The 
painstaking  researches  of  Sudhoff  and  Neuburger,  on  physicians' 
libraries  in  the  Middle  Ages,  go  to  show  that  the  extant  inven- 
tories of  medical  books  and  manuscripts,  collected  b^  various 
medieval  physicians,  tally  very  closely  as  to  items  with  the  tables 
of  contents  of  some  of  these  huge  medical  anthologies.  The  vogue 
of  printing  such  anthologies  continued  straight  through  the 
Renaissance  period  down  to  the  seventeenth  century.  We  find 
notable  examples  in  the  immense  "Gynaecia,"  or  anthologies  of 
gynecological  writings,  edited  by  Caspar  Wolf,  Caspar  Bauhin 
and  Israel  Spach;  in  the  collections  on  syphilis  made  by  Massa, 
Luisinus,  and  others,  in  the  Aldine  "Medici  antiqui  omnes" 
(1547),  in  the  Venetian  collection  "De  Balneis"  (1553),  or  in  the 
surgical  anthologies  of  Conrad  Gesner  (1555)  and  Peter  Uffenbach 
(1610).  Huge,  heavy  and  unwieldy  as  these  volumes  seem  to  us 
today,  there  were  yet  excellent  reasons  for  their  existence.  Printed 
books  in  those  early  days  were  an  expensive  luxury  and  the  expe- 
dient of  printing  the  best  medical  treatises  of  the  time  in  one 
volume  was  an  economic  one;  indeed,  we  find  the  same  tendency 
today  in  our  innumerable  systems  and  encyclopedias  of  medicine. 
With  a  few  such  folios  about  him,  the  medieval  physician  had  no 


FOREWORD  xi 

need  of  visiting  a  public  library,  had  any  such  existed.  These 
private  collections  were,  in  fact,  the  only  medical  libraries  of  the 
period. 

Now,  in  our  own  time,  the  making  of  anthologies,  whether  of 
.Vientific  or  secular  literature,  has  become  a  highly  specialized 
matter,  almost  a  fine  art,  to  be  practiced  with  impunity  only  by 
the  expert,  to  whom  familiarity  with  the  long  sifting  process  of 
the  ages  has  given  a  special  feeling  for  real  values.  One  has  only  to 
think  of  Bartsch's  "Chrestomathie  provencale,"  of  the  selections 
made  by  Diez,  Bartsch  and  Gaston  Paris  from  the  old  French  and 
other  Romance  languages,  of  Jastrow's  collection  of  Assyro- 
Babylonian  birth-omens,  of  Vigfusson  and  Powell's  "Corpus 
poeticum  boreale,"  of  Charles  Lamb's  selections  from  the  Eliza- 
bethan dramatists,  of  the  "  Anthropophyteia  "  and  "Kruptadia,"  of 
the  many  collections  of  prose,  verse,  and  folklore  in  all  languages. 
To  many  of  us  of  Scotch  extraction,  how  dear  are  such  collections 
as  Allan  Ramsay's  "Evergreen"  or  Professor  Child's  "English 
and  Scottish  Ballads!"  In  the  matter  of  selection,  how  superior 
are  Saintsbury's  "French  Lyrics"  to  Parton's  "French  Par- 
nassus" or  almost  any  recent  anthology  of  verse  to  Emerson's 
"Parnassus!"  In  science,  we  have  such  remarkable  anthologies 
in  extenso  as  Ostwald's  "Klassiker"  or  the  publications  of  the 
Alembic  Club;  in  theology  the  collections  of  Mansi  and  the  Abbe 
Migne;  in  classical  literature,  the  Teubner  texts  and  the  Loeb 
bilinguals;  in  Oriental  literature,  such  collections  as  those  of  Max 
Miiller;  in  medicine,  Sudhoff's  "Klassiker,"  the  collection  of  C.  G. 
Gruner  on  sweating  sickness,  and  of  Astruc  and  of  C.  H.  Fuchs  on 
syphilis,  Chereau's  "Parnasse  medical  francais,"  Camac's  "Epoch- 
Making  Contributions  to  Medicine"  and  Comrie's  "Syllabus  and 
Specimen-Extracts."  Works  of  this  kind  are  of  unusual  value  to 
the  medical  historian.  In  the  interest  of  isolating  the  best 
things  in  the  medical  literature  of  the  past  and,  in  particular,  of 
isolating  and  collecting  the  textual  sources  of  the  discoveries, 
inventions  and  advances  in  the  different  branches  of  medical 
science,  it  is  probable  that  their  number  will  increase. 

Here  we  must  differentiate  clearly  between  the  anthology,  the 
chrestomathy  and  the  source  book.  An  anthology  connotes  a 
homogeneous  selection  of  the  very  best  material,  of  whatever  kind; 
a  chrestomathy  connotes  a  gathering  of  specimen  extracts  from 
the  literature  of  a  foreign  language;  a  source  book  is  necessarily 


xii  FOREWORD 

made  up  of  the  basic  original  texts  of  a  given  set  of  scientific 
discoveries  and  inventions.  Thus  Swinburne's  selections  from 
Coleridge  and  Byron  are  genuine  anthologies,  selections  of  the 
very  best  of  these  poets  from  a  poet's  viewpoint,  in  comparison 
with  which  Matthew  Arnold's  selections  from  Wordsworth  anr 
Byron  seem  collections  made  up  of  extracts  of  mean  average 
merit  only,  like  Saintsbury's  "Specimens  of  French  Literature," 
which  is  a  genuine  chrestomathy.  Dr.  Camac's  collection  of 
"Epoch-Making  Contributions  to  Medicine,"  is  a  genuine  an- 
thology; Professor  Comrie's  "Syllabus  of  Specimen  Extracts"  from 
the  earlier  medical  writers  is  a  chrestomathy;  Fuchs'  "Early 
Tracts  on  Syphilis,"  or  Haeser's  early  accounts  of  hitherto 
unknown  epidemic  diseases  in  medieval  chronicles,  make  true 
source  books. 

The  present  collection  is,  at  one  and  the  same  time,  an  antho- 
logy and  a  chrestomathy  and  a  source  book.  Dr.  Ruhrah  has 
given  here  not  only  the  very  best  that  the  older  literature  of  pediat- 
rics affords,  but  he  has  followed,  too,  the  wise  counsel  of  Billings 
at  the  beginning  of  his  "History  of  Surgery,"  that  if  readers  are  to 
enjoy  the  history  of  a  medical  speciality  "it  is  necessary  to  consult 
the  original  documents  ...  to  get  the  flavor  of  the  older 
writers."  Another  essential  element  of  the  editor's  function,  the 
interpretative,  is  deployed  on  occasion,  for  much  of  this  archaic 
pediatry  is  speculative  or  obscure.  The  extracts  from  the  Greek 
classics  and  from  the  writings  anterior  to  the  Renaissance  period 
are  brief  yet  sufficient  and  to  the  point.  With  the  single  exception 
of  the  chapters  of  Soranus  of  Ephesus  and  Rhazes,  pediatrics  did 
not  begin  to  be  specialized  in  separate  treatises  until  the  sixteenth 
century;  there  are  too  many  wide  gaps  in  the  knowledge  of  the 
ancient  writers  to  justify  complete  citation.  The  Persian  Rhazes, 
for  example,  with  all  his  Attic  pungency  in  clinical  delineation, 
frequently  gives  no  more  than  a  curt  definition  of  some  infantile 
disease,  followed  by  an  embarrassing  array  of  the  fantastic  reme- 
dies common  to  Arabian  polypharmacy.  But  his  accounts  of  small- 
pox, measles,  and  infantile  diarrhea,  like  Felix  Platter's  case  of 
thymus-death,  are  classical — fit  material  for  a  source  book.  Upon 
the  observation  of  the  older  writers  from  Hippocrates  to  Rhazes, 
the  main  body  of  traditional  pediatric  doctrine  was  gradually  built 
up,  but  it  was  during  the  three  centuries  following  the  invention 
of  printing  that  the  subject  gradually  expanded  into  a  specialty, 


FOREWORD  xiii 

in  the  writings  of  such  men  as  Thomas  Phaer,  Felix  Wiirtz, 
Franciscus  Sylvius,  Francis  Glisson,  Walter  Harris,  Robert 
Whytt,  Michael  Underwood  and  William  Heberden. 

By  the  second  half  of  the  nineteenth  century,  pediatrics  was 
.a  going  scientific  concern;  its  rapid  growth  was  due  to  the 
r  increased  interest  in  children  as  assets  of  the  state.  Of  the  earlier 
pediatric  tracts,  three  are  given  in  full,  those  of  Thomas  Phaer, 
Felix  Wiirtz  and  William  Heberden.  Phaer's  little  tract  is  the 
first  English  pediatric  treatise  published  in  the  vernacular  and  if 
we  open  it  anywhere,  we  are  at  once  aware  of  the  writer's  rugged 
common  sense  and  (what  is  common  to  English  clinicians)  his 
unquestionable  power  of  localizing  the  salient  and  definite  clinical 
aspects  of  a  disease.  By  comparing  his  work  with  that  of  the 
earlier  writers,  one  can  perceive  how  the  general  fabric  of  knowl- 
edge in  a  book  on  the  practice  of  medicine  or  obstetrics  or 
pediatrics  has  been  built  up,  bit  by  bit,  from  the  sifting  of  the 
accumulated  knowledge  of  the  past,  with  the  addition  of  some 
shreds  of  newer  and  better  material. 

The  little  treatise  of  Felix  Wiirtz  is  one  of  the  most  striking 
things  in  all  medical  literature.  It  has  a  genuine  scientific  value  in 
that  it  is  the  first  definite  treatise  on  infantile  orthopedics,  but 
what  arrests  our  attention  is  the  splendid  humane  spirit  of  the 
author.  So  intense  is  this  writer's  feeling  for  the  welfare  of  children 
and  so  keen  his  indignation  at  the  cruel  treatment  which  many  of 
them  endured  in  this  period,  that  his  tract  reads  like  a  sermon. 
He,  the  wandering  surgeon,  who  would  have  been  treated  as  an 
outcast  in  any  Latin  society  of  the  time,  looms  larger  than  any  of 
his  contemporaries  in  the  history  of  pediatrics  and  of  child  study. 
He  is  like  Luther  and  the  other  reformeis  of  the  age,  and  to  read 
his  stirring  sentences  is  to  be  reminded  of  what  the  sage  of  Concord 
said  of  Jacob  Behmen:  "His  heart  beats  so  high  that  the  thump- 
ing against  his  leathern  coat  is  audible  across  the  centuries." 
In  the  little  compend  of  William  Heberden,  we  encounter  a 
man  of  entirely  different  type.  Although  this  tract  was  published 
after  the  elder  Heberden's  death  and  is  therefore  credited  to  his 
son,  who  bore  the  same  given  name,  yet,  as  Ruhrah  says,  it  bears 
all  the  hallmarks  of  production  by  that  great  physician  who  is 
the  most  remarkable  clinician  between  Sydenham  and  Bright 
and  the  greatest  Latin  and  Hebrew  scholar  among  the  medical 
men  of  his  time.  So  perfect  in  matter  and  manner  are  Heberden's 


xiv  FOREWORD 

delineations  of  disease  that  the  German  Soemmering  called  him 
"the  truly  Hippocratic  physician."  These  qualities  shine  out 
everywhere  in  this  tiny  pediatric  treatise.  The  chapters  are  of 
almost  unheard-of  concision,  yet  unquestionably  they  do  give, 
in  the  space  of  a  booklet  for  one's  vest  pocket,  all  that  was  really 
known  of  the  diseases  of  children  at  the  end  of  the  eighteenth 
century.  Although  this  book  was  published  in  the  year  1804,  & 
belongs,  in  reality,  to  the  preceding  century.  Originally  written 
in  Latin,  no  doubt  by  the  elder  Heberden,  the  English  version 
is  almost  unknown  today,  even  to  followers  of  the  pediatric  art. 
In  inviting  the  attention  of  the  medical  profession  to  the 
present  collection,  it  is  proper  to  say  a  word  as  to  its  origin. 
In  preparing  a  "History  of  Pediatrics,,  for  Dr.  Abt's  "System 
of  Pediatrics,"  it  was  necessary  for  me  to  give  a  detailed  account 
of  the  contents  of  the  individual  pediatric  texts  and  treatises 
up  to  the  time  of  Billard.  This  task  was  rendered  relatively 
easy  through  the  unique  collection  of  pediatric  literature  in 
the  Surgeon-General's  Library.  In  endeavoring  to  ascertain 
the  status  of  the  more  recent  textbooks  and  systems,  the  analysis 
of  which  is  not  the  historian's  province,  but  a  question  de  metier, 
I  applied  to  a  number  of  leading  pediatrists  of  the  country  for 
an  expression  of  opinion.  Among  these,  Ruhrah  was  particularly 
helpful,  through  his  wide  reading  in  the  modern  authors,  from 
Rilliet  and  Barthez  to  Pfaundler  and  Schlossman,  from  Billard 
to  Filatoff  and  Figueira.  Through  this  pleasant  relationship, 
he  was  led  to  a  deeper  study  of  the  older  authors  and  so  made 
the  present  collection.  As  good  wine  needs  no  bush,  it  is  not 
necessary  for  me  to  enlarge  upon  the  worth  and  value  of  these 
tracts  and  texts.  The  collection  has  been  made  in  the  same  spirit 
in  which  our  beloved  master,  Sir  William  Osier,  made  his  great 
Bibliotbeca  prima  and  secunda,  one  of  the  great  literary  landmarks 
of  medical  science. 

Fielding    H.    Garrison,    m.d. 

Army  Medical  Museum 
Washington,  D.  C. 
April,  1925. 


CONTENTS 

Paqb 

Preface vii 

Foreword fx 

By  Way  of  Introduction xix 

Hippocrates i 

soranus  of  ephesus 4 

Aretaeus,  the  Cappedocian 8 

Oribasius 12 

Aetius  of  Amida 15 

Paul  of  Aegina 17 

Rhazes 19 

From  the  Ancients  and  Arabians  to  the  Medieval  Pediatrists    22 

The  Pediatric  Incunabula 27 

Paulus  Bagellardus 28 

Bartholomaeus  Metlinger 71 

Cornelius  Roelans 99 

Sebastian  Oestereicher 135 

Leonelli  Faventide  Victorius 139 

Jonas  and  Raynalde 142 

Thomas  Phaer 147 

Felix  Wurtz 196 

hleronymus  mercurialis 221 

Felix  Platter 237 

GUILLAUME   DE   BaILLOU    (BaLLONIUS) 24O 

Simon  de  Vallembert 247 

Philip  Gerhard  Gruling 252 

Francis  Glisson 254 

Robert  Pemell 285 

Francis  Sylvius  as  a  Pediatrist 298 

Richard  Wiseman 309 

Thomas  Sydenham 321 

J.  S.    . 334 

XV 


xvi  CONTENTS 

Page 

John  Mayow 341 

Walter  Harris 350 

The    First    American    Pediatric    Publication,    by    Thomas 

Thatcher 365 

Wolfgang  Hoefer 370 

Nils  Rosen  von  Rosenstein 373 

William  Cadogan 382 

The  First  Pediatric  Anthology  in  English 400 

Robert  Whytt 401 

Benjamin  Rush 423 

Hezekiah  Beardsley 432 

Samuel  Thomas  Soemmering 437 

George  Armstrong 440 

Michael  Underwood 447 

Samuel  Bard 454 

The  Pediatric  Poems 465 

The  Herberdens 519 

Friedrich  Ludwig  Meissner 556 

An  Additional  Bibliography  of  Pediatric  Literature    .    .    .   564 

Index  of  Personal  Names 579 

Index  of  Subjects 587 


LIST  OF  ILLUSTRATIONS 

Page 

Headband   from   Harris,    Gualteri:  Tractatus   de   Morbis  Acutis 

Infantum  Variis  Observationibus.  Genevae,  1727 1 

Decorative  initial  by  Frederic  W.  Goudy 1 

Title  page  of  Dietz'  edition  of  Soranus 6 

Portrait  of  Aretaeus,  the  Cappedocian 8 

Portrait  of  Paul  of  Aegina 17 

Last  page  of  the  first  edition  of  Bagellardus,  showing  the  printer's 

signature 30 

First  page  of  Bagellardus 35 

Title  page  of  the  fourth  edition  of  Metlinger 73 

Title  page  of  the  1549  edition  of  Metlinger  and  a  rendition  of  the 

pediatric  part  of  Louffenburg's  poem,  "Versehung  des  Leibs".     76 

First  page  of  Metlinger's  work 78 

A  page  from  Roelan's  book 101 

Title  page  of  the  work  of  Sebastian  Oestereicher 136 

Title  page  of  Phaer's  translation  of  the  Aeneid 148 

Title  page  of  "The  Regiment  of  Life"  translation  by  Thomas  Phaer  153 

First  page  of  Thomas  Phaer's  book 156 

Title  page  of  the  English  translation  of  Felix  Wurtz'  "Treatise  of 

Surgery"  which  contains  his  "Children's  Book" 198 

First  page  of  Felix  Wurtz*  "The  Children's  Bo'ok" 200 

Portrait  of  Hieronymus  Mercurialis 223 

Title  page  of  Mercurialis'  book  on  "Diseases  of  Children" 224 

Portrait  of  Felix  Platter  (1536-1614) Facing  238 

Portrait  of  Ballonius 241 

Title  page  of  Ballonius 243 

Title  page  of  Vallembert's  "Cinq  Livres" 249 

Portrait  of  Francis  Glisson  (1597- 1677) Facing  256 

Frontispiece  of  Glisson's  book  on  rickets Facing  258 

Title  page  of  the  first  edition  of  Glisson's  book  on  rickets 264 

Title  page  of  the  third  edition  of  Glisson's  work  on  rickets 267 

A  page  of  Glisson's  "De  Rachitide"  showing  an  illustration 276 

Title  page  of  Robert  Pemell's  book 291 

Portrait  of  Francis  Sylvius  (1614-1672) Facing  300 

xvif 


xviii  LIST  OF  ILLUSTRATIONS 

Pagb 

English  edition  of  Franciscus  Sylvius'  book  on  the  diseases  of 

children 306 

Portrait  of  Richard  Wiseman  (1 622-1 676) Facing  310 

Portrait  of  Thomas  Sydenham  (1624- 1689) Facing  322 

Title  page  of  a  work  by  "J.  S." 336 

Portrait  of  John  Mayow  (1640-1679) Facing  342 

Title  page  of  John  Mayow's  book  on  rickets 346 

Title  page  of  the  book  of  Walter  Harris 351 

The  first  American  contribution  to  pediatrics  (1677- 1678) 367 

Title  page  of  Wolfgang  Hoefer's  "Hercules  Medicus" Facing  370 

Portrait  of  Nils  Rosen  von  Rosenstein  (1706- 1773) Facing  374 

Title  page  of  von  Rosenstein,  German  edition 379 

Title  page  of  Cadogan's  "Essay  upon  Nursing" 383 

Portrait  of  William  Cadogan Facing  384 

Title  page  of  Whytt's  "Observations  on  Dropsy  of  the  Brain". .  . .  402 

Portrait  of  Robert  Whytt  (1714-1766). .   Facing  404 

Title  page  of  the  volume  containing  Beardsley's  account  of  pyloric 

stenosis 434 

Portrait  of  Samuel  Thomas  Soemmering  (1755- 1830) Facing  438 

Soemmering's  plate  showing  a  case  of  achondroplasia 438 

Title  page  of  the  book  of  George  Armstrong 441 

Early  devices  used  in  infant  nursing Facing  446 

Title  page  of  Underwood's  book 448 

Portrait  of  Samuel  Bard  (1742-1821) Facing  454 

Title  page  of  Samuel  Bard's  work  on  diphtheria 455 

First  page  of  "Versehung  des  Leibs" 466 

Pages  from  "Versehung  des  Leibs" 471,  476,  478,  481,  483,  485 

Title  page  of  the  English  translation  of  "La  Balia" 487 

A  page  of  "La  Balia" 489 

Title  page  of  "  Callipaedia  " 493 

Title  page  of  the  English  translation  of  "Paedotrophia" 504 

Portrait  of  Hugh  Downman  (1740-1809) Facing  514 

Title  page  of  Hugh  Downman's  poem 515 

Portrait  of  William  Heberden  the  elder  (1 710-180 1) Facing  520 

Title  page  of  Heberden's  "Epitome" 524 

Portrait  of  William  Heberden  the  younger  (1767- 1854) Facing  526 

Title  page  of  Meissner's  book  on  the  diseases  of  children 557 

Portrait  of  Friedrich  Ludwig  Meissner  (1796- 1860) Facing  558 

Title  page  of  Meissner's  "Grundlage" 559 


o 


BY  WAY  OF  INTRODUCTION 

F  the  value  of  reading  the  older  writers  there  can  be  no 
question,  but  since  it  has  been  declared  that  "history  is  a 
fable  agreed  upon,"  in  other  words  that  the  historian  is  a 
kind  of  novelist,  it  may  not  be  out  of  place  to  try  to  estimate 
just  what  this  volume  is,  and  to  make  clear  why  the  neglected 
masters  of  medicine  of  other  times  should  be  sought  out,  not  to 
honor  them  as  some  would  have  it,  but  for  our  own  profit  and  good. 

To  the  average  medical  student  and  physician,  the  literature 
of  the  present  seems  to  hold  all  that  is  worth  while;  they  give 
scant  heed  to  the  seers  who  laugh  to  scorn  much  that  masquer- 
ades as  new.  Medical  truth,  medical  knowledge,  medial  litera- 
ture is  like  the  world,  a  continuous  performance !  tragedy,  drama 
or  comedy,  as  you  will,  which  each  of  us  visit  a  little  while  until 
we,  too,  pass  on.  Some  are  on  the  stage  shouting  and  gesticulating, 
some  in  the  chorus,  some  only  auditors  at  the  great  drama.  These 
last  rise  when  the  anthem  is  played,  applaud  a  particularly 
showy  bit  of  acting  or  loud  speech,  and  usually  in  this  they  follow 
the  claque.  There  are  the  critics,  some  learned  and  some  other- 
wise, but  all  striving  with  their  multitude  of  dissentient  opinions 
to  guide  the  poor  auditor,  or,  at  least,  to  fatten  their  own 
pocketbooks> 

The  unread  physician  is  like  a  man  in  the  theater  without 
a  program  or  a  libretto  or  often,  perhaps,  without  even  a  knowl- 
edge of  the  language  of  the  stage.  He  is  like  a  deaf  man  at  an 
opera.  Someone  who  has  been  watching  the  play  before  he  came 
in  may  tell  him  something  about  it;  who  the  principal  characters 
are;  who  it  is  that  sings  so  sweetly,  so  convincingly.  He  may  gain  a 
slender  knowledge  of  the  plot  from  what  the  actors  say  or  do,  and 
that  is  all.  The  jester  enters,  makes  a  loud  noise  with  an  empty 
bladder  on  the  end  of  a  stick,  tweaks  the  nose  of  the  king  or  his 
chancellor,  cracks  his  time-honored  jest  and  vanishes  amid  the 
laughter  and  applause  of  the  delighted,  if  uninitiated,  audience. 
Character  after  character  appears  and  disappears,  most  of  them 

xix 


xx  BY  WAY  OF  INTRODUCTION 

the  same  old  familiar  faces,  though  sometimes  with  new  names 
and  new  costumes.  The  auditor  gasps  and  wonders.  A  timid 
voice  speaks  a  great  truth,  but  no  one  pays  attention  and  presently 
the  stage  manager  pulls  the  speaker  from  the  stage  while  the  clown 
and  the  trained  dogs  hold  the  attention  of  the  audience. 

A  century  or  two  later,  the  same  truth  is  told  again,  but  now 
the  spotlight  is  on  the  handsome  actor,  with  a  wonderful  voice, 
mouthing  his  nothings  most  delightfully.  Again  the  audience 
pays  no  attention,  but  after  many  repetitions,  the  stage  is  set 
for  Truth  and,  amid  great  applause,  some  one  or  a  group  parade 
Her  with  great  pomp,  as  if  for  the  first  time.  The  audience  gasps 
again  and  asks  why  She  was  not  brought  out  before:  so  wonderful 
She  is !  Had  he  but  known,  had  he  paid  attention — he  had  heard 
it  long  ago,  but  Now  it  is  the  wonderful,  new  thing.  But  perhaps 
it  was  not  on  the  stage  while  he  was  in  the  audience.  Well,  it 
was  set  down  in  the  account  of  the  play,  but  he  was  too  indolent, 
too  busy,  or  else  too  lazy  to  read  it. 

Is  this  a  jest?  Far  from  it!  Garrison,  always  a  source  of  infor- 
mation as  well  as  of  inspiration,  has  furnished  some  two  score 
examples  of  medical  truths,  appearing  and  reappearing.  Take  the 
recent  example  of  the  transmission  of  typhus  fever  by  the  louse. 
Typhus  fever,  the  scourge  of  armies,  the  study  for  centuries  of 
army  surgeons!  Did  not  Tobias  Cober,  of  Gorlitz,  in  his  "Observa- 
tiones  castrenses"  (Frankfurt,  1606),  a  book  on  camp  diseases, 
call  attention  to  the  connection?  He  did,  but  no  one  heeded; 
which  recalls  the  old  saying  that  the  sanitarian  is  like  the  old 
Greek,  Cassandra,  who  had  the  gift  of  prophecy,  but  the  curse 
that  no  one  would  believe  her. 

Since  Percival  Pott  called  attention  to  what  is  now  called 
Pott's  disease,  in  1779,  the  world  has  heeded;  but  did  not  Hippo- 
crates note  the  relation  between  phthisis  and  spinal  deformity, 
and  later  Avicenna,  and  Platner  in  1744? 

We  prate  about  our  modernity;  that  there  was  never  anything 
like  it,  forgetting  the  sanitary  plumbing  and  drainage  pipes  of 
Crete  (3400  b.  c).  The  nineteenth  century  boasts  the  relation  of 
the  mosquito  to  malaria.  The  idea  is  in  Susrata.  Bubonic  plague 
and  rats  have  a  new  significance,  but  the  association  is  in  the 
ancient  Hindu  Bhagavata  Purana,  recurs  in  Samuel,1  in  Defoe's 
"Journal  of  the  Plague  Year,"  and  elsewhere. 

1 1  Samuel,  v,  6,  8;  vii,  4,  5. 


BY  WAY  OF  INTRODUCTION  xxi 

When  we  isolate  patients  with  infectious  diseases  and  inciner- 
ate the  infectious  material  we  have  come  as  far  up  in  the  preven- 
tion of  diseases  as  Moses.2 

Medical  truths  are  like  the  flower  of  the  field  that  is  cut 
down,  like  the  grass  that  withereth,  but  the  root  or  the  seed 
remains  and  presently  it  has  sprung  up  again,  perhaps  only  to  be 
trampled  under  foot  unheeded.  But  real  truths  and  ideas  are  hard 
to  kill,  even  erroneous  ideas  like  weeds  are  unfortunately  endowed 
with  almost  a  charmed  life.  Galen  spoke,  and  the  medical  world 
stood  still  for  centuries.  Some  one  has  said  that  ideas  are  the  only 
conquerors  whose  victories  last.  They  last  awhile  and  then 
descend  into  oblivion,  to  be  resurrected  centuries  hence.  .  .  . 
Bearing  this  in  mind,  read  the  older  writers  and  see  how  pregnant 
they  are  with  ideas. 

The  pediatric  knowledge  of  the  ancients  is  contained  in 
the  "Ebers  Papyrus,"  in  the  "Aphorisms"  and  other  writings  of 
Hippocrates,  in  the  "Syriac  Book  of  Medicine,"  the  Hindu  books, 
in  the  splendid  treatise  of  Soranus  of  Ephesus,  in  the  Babylonian 
"Talmud,"  the  "Koran,"  and  in  sundry  references  to  the  diseases 
of  infant  life  by  other  earlier  writers.  Aetius,  Paulus  Aginetas, 
Rhazes  and  Avicenna,  all  wrote  more  or  less  on  the  subject  of 
pediatrics,  interwoven  with  their  other  clinical  observations;  but 
perhaps  of  more  interest  are  the  books  written  in  the  Middle  Ages 
and  in  the  period  following.  There  have  been,  previous  to  the  work 
of  Garrison,  but  few  excursions  into  the  field  of  pediatric  history. 
Sudhoff,  the  indefatigable  professor  of  Leipzig,  brought  to  light 
many  of  the  old  texts  in  his  journeys  through  the  libraries  and 
museums  of  Europe.  Briining  and  Forsyth  have  written  about  the 
history  of  infant  feeding;  Hennig,  Escherich,  Jacobi  and  a  few 
others  have  contributed  historical  sketches.  It  was,  indeed,  Jacobi 
who  called  attention  to  Meissner's  "Grundlage"  in  his  St.  Louis 
address.  This  "Grundlage"  is  a  catalogue  of  most  of  the  contri- 
butions of  pediatrics  up  to  the  year  1850,  arranged  chronologi- 
cally under  diseases;  it  is  an  extraordinarily  valuable  work  for 
anyone  disposed  to  look  up  the  earlier  writers.  The  first  part  is  re- 
printed further  on.  Garrison  has  written  a  "History  of  Pediatrics " 
for  the  "System"  which  Abt  is  editing.  He  was  the  first,  perhaps, 
to  go  to  the  original  texts  for  much  of  his  material.  It  has  been 
a  privilege  to  have  read  this  manuscript,  to  have  had  many  con- 

2  Leviticus,  xiii-xv. 


xxii  BY  WAY  OF  INTRODUCTION 

versations  and  considerable  correspondence  about  it,  and  out  of 
this  grew  the  idea  that  it  would  be  interesting  to  collect  from  the 
earlier  writings  an  anthology,  not  of  curious  or  absurd  things, 
but  of  the  real  contributions  which  have  helped  to  make  pediatrics 
what  it  is  today. 

There  are  three  early  pediatric  books  printed  before  the 
year  1500  that  survive  today.  One  by  Bartholomew  Metlinger, 
one  by  a  Flemish  physician,  Cornelius  Roelans  of  Mechlin,  and  one 
by  Paulus  Bagellardus.  Bagellardus  was  the  first  to  be  printed  and 
appeared  in  1472.  There  were  three  editions  of  it  among  the 
incunabula  (1472,  i486,  1487),  of  which  there  are  two  beautiful 
examplars  (1472,  1487)  in  the  Library  of  the  Surgeon-General, 
as  fresh  almost  as  if  they  had  come  from  the  press  yesterday. 
The  work  of  Bagellardus  is  better  known  through  the  volume  of 
Peter  of  Toledo.  This  was  printed  in  1538  and  consists  of  the 
text  of  Bagellardus  with  notes  by  the  editor.  Metlinger's  book 
was  printed  in  1474  and  went  through  many  later  editions.  Roelans 
was  printed  about  1483-4,  but  remained  a  sealed  book  to  us  until 
it  was  unearthed  by  Sudhoff,  who  translated  part  of  it  into 
modern  German.  Roelans,  however,  survives  for  us  in  the  work 
of  perhaps  the  best  known  of  the  early  pediatric  writers, 
Sebastianus  Austrius,  whose  book  was  published  in  1540  at  Basel. 
He  took  the  work  of  Roelans,  as  Sudhoff  has  shown,  and  trans- 
lated what  he  designated  the  kitchen  Latin  of  the  author,  into 
something  more  satisfactory,  adding  notes  of  his  own.  He  very 
casually  mentions  Roelans  on  the  third  page,  and  then  no  more 
about  him. 

The  birth  of  English  pediatric  literature  took  place  in  the 
sixteenth  century  when  Thomas  Phaer  wrote  his  "Book  of 
Children."  Before  this  whatever  was  of  pediatric  import  was 
contained  in  other  writings.  The  seventeenth  and  eighteenth 
centuries  contain  a  series  of  readable,  delightful  volumes. 

Perhaps  no  age  is  more  interesting  or  enlightening  than 
the  seventeenth  and  eighteenth  centuries.  These  were  periods 
of  great  charm  and  if  the  latter  lacks  the  glory  of  the  Elizabethan, 
it  has  many  wonderful  things  to  offer.  It  was,  in  spite  of  all 
that  happened,  an  age  of  exquisite  leisure,  of  slow  travel,  of 
long  novels  and,  alas,  of  long-winded  medical  writers  as  well, 
but  there  was  time  for  contemplation  and  thought  such  as  exists 
no  longer.  It  is  a  commonplace  of  recent  observation,  that  the 


BY  WAY  OF  INTRODUCTION 


XXIII 


more  labor-saving  and  time-saving  devices  we  have,  the  less 
leisure  we  have.  One  more  invention  like  the  telephone  and  quiet, 
uninterrupted  thought,  for  most  of  us,  will  well  nigh  perish 
from  the  earth. 

Some  of  these  volumes  were  written  in  Latin  and  subsequently 
translated  into  English,  while  some,  like  those  of  Phaer  and  Pemel, 
who  realized  the  value  of  putting  their  thoughts  in  the  tongue  best 
understood  by  the  unlearned,  are  in  English.  Some  of  these  texts 
are  brief,  and  can  be  reprinted  in  their  entirety,  or  nearly  so, 
whilst  others,  like  Glisson's  book  on  rickets,  are  almost  pain- 
fully verbose  and  can  be  reprinted  only  in  fragments,  but  enough 
to  show  the  reader  what  sort  of  writings  they  are.  John  Mayow 
gave  a  shorter  account  of  Glisson's  work  on  rickets  and  in  it 
one  may  find  a  description  of  the  passive  hyperemia  treatment 
recently  exploited  by  Bier. 

Do  you  know  Felix  Wiirtz,  the  delightfully  blunt  old  surgeon 
of  Basel?  If  not,  you  have  a  real  treat  in  his  pages;  another  in 
the  polished  and  studious  Heberden.  Sylvius  was  somewhat  of 
a  pediatrist,  though  scorned  by  Harris,  who  appropriated,  almost 
as  his  own,  one  of  Sylvius*  pet  ideas.  There  are  also  Cadogan  and 
Armstrong,  forerunners  of  the  cult  of  infant  welfare.  Of  interest, 
too,  are  some  pediatric  poems  of  the  period,  which  deserve  at 
least  a  passing  notice. 

The  seventeenth  century  saw  the  real  awakening  of  clinical 
observation.  In  olden  days  Hippocrates  was  a  master  hand  and 
Aretaeus  knew  the  art  of  clinical  description;  others  possessed 
it  to  a  lesser  degree;  for  centuries  it  languished  to  be  revived 
by  Sydenham,  who  had  common  sense  enough  to  enable  him  to 
get  away  from  the  vain  theorizing  of  his  age  and  the  ages  which 
preceded. 

These  centuries  knew  the  horrors  of  the  four  Pharmacopeias 
of  London,  1618,  1650,  1677,  and  1721,  which  contained  a  series 
of  therapeutic  agents  which  would  make  a  modern  manufacturer 
of  animal  extracts  either  blush  with  shame  or  turn  green  with 
envy.  This  collection  of  filth,  the  heritage  from  Egypt,  Greece 
and  Rome,  increased  at  compound  interest,  was  finally  dissipated 
by  the  common  sense  of  Sydenham  and  the  satire  of  Heberden 's 
"Essay  on  Mithridatium  and  Theriaca,,,  1745,  and  by  the  end  of 
the  eighteenth  century,  wood  lice  were  the  only  remedy  of  the 
kind  remaining.  This  achievement  alone  would  make  the  age  one 


xxiv  BY  WAY  OF  INTRODUCTION 

to  be  revered;  this  cleansing  of  the  Augean  stables  of  therapeutics 
was  a  great  advance  and  perhaps  ere  long  another  Hercules  will 
again  appear. 

This  was  an  age  which  gave  us  many  potent  drugs,  the  prod- 
ucts of  the  centuries  of  experience  with  herbals  and  of  that 
of  the  users  of  simples,  culminating  in  the  discovery  of  the  real 
value  of  foxglove,  belladonna,  hyoscyamus,  and  the  like.  But 
it  took  two  centuries  more  to  get  the  useless  plants  discarded 
and  perhaps  on  further  investigation  some  may  be  recalled.  This 
was  the  age  of  Harvey  and  the  discovery  of  the  circulation  of  the 
blood,  which  gave  a  new  impetus  to  surgery  and  physiology,  of 
Felix  Platter,  who  in  1614,  described  thymus  death,  which  may  be 
a  point  of  departure  for  the  much  later  investigations  dealing 
with  the  functions  and  pathology  of  the  ductless  glands.  It  was 
no  sterile  age,  but  one  of  great  beginnings ! 

This  is  a  sort  of  personally  conducted  tour  through  the 
literature  of  the  sixteenth,  seventeenth  and  eighteenth  centu- 
ries. Such  tours  have  their  advantages  and  disadvantages.  Many 
there  are,  indeed,  who  would  not  travel  at  all  were  it  not  that 
someone  else  has  all  the  worry  and  bother  of  the  journey.  One 
is  told  where  to  go,  when  to  go,  how  to  go,  nay  better,  one  is 
conveyed  from  place  to  place.  The  double-starred  and  single- 
starred  items  of  the  guide  book  are  visited,  explained  and  lectured 
about.  One  is  instructed  and  returns  home — like  Heine — with 
something  to  talk  about. 

Few  there  are  who  journey  into  the  dim  vistas  of  other  ages 
and  fewer  still  who  haunt  the  places  made  holy  by  the  pediatrists 
of  the  past.  The  journey  then  is  into  a  strange,  an  almost  unknown 
country.  But  few  may  visit  it.  Only  those  who  have  access  to  the 
books  of  the  early  writers  may  enter.  But  having  made  the  journey 
through  rare  good  fortune,  the  writer  returns  to  share  it  with  any 
who  care  to  take  the  trip.  The  excitement  of  the  quest  of  adventure 
in  unknown  places  may  be  lacking,  but  one  shall  waste  no  time. 
An  easy  chair,  a  good  light,  this  little  book — the  magic  carpet  is 
spread;  step  on  and  come,  the  centuries  are  yours! 

It  is  not  my  purpose  to  give  any  extended  account  of  pediatrics 
as  practiced  or  written  in  ancient  times;  my  story  begins  with  the 
introduction  of  printing  and  goes  as  far  as  the  beginning  of  the 
nineteenth  century;  but  it  is  well  to  examine  briefly  what  real 
contributions  have  been  made  in  early  times.  A  more  extended 


BY  WAY  OF  INTRODUCTION  xxv 

account  of  this  subject  will  be  found  in  Garrison's  "History  of 
Pediatrics"  in  Abt's  "System." 

The  ancient  writers,  it  will  be  seen,  did  not  neglect  pediatrics 
even  if  they  did  not  separate  it  from  the  remainder  of  medical  lore. 
Just  enough  of  each  author  considered  is  given  to  whet  the 
appetite  and  prepare  the  palate  for  the  piece  de  resistance  which 
follows.  This,  then,  is  a  sort  of  literary  hors  d'oeuvres  which  may 
be  tasted  or  passed  by  as  suits  the  fancy  of  the  reader. 


PEDIATRICS  OF  THE  PAST 


HIPPOCRATES 

[460-37O  B.  C] 

LL  knowledge  of  clinical  medicine  goes 
back  to  Hippocrates.  The  clinical  acumen  of 
the  old  Greek  is  only  appreciated  by  one  who 
reads  and  rereads  the  Hippocratic  canon. 
The  recent  outbreak  of  epidemic  enceph- 
alitis recalls  the  aphorism,  "Lethargy 
with  trembling  is  bad."  Did  this  refer  to 
the  myoclonic  type  of  encephalitis,  which 
many  today  believe  to  have  an  unusually 
bad  prognosis?  The  passages  of  pediatric  import  in  the  Hippo- 
cratic canon  were  excerpted  and  analyzed  by  the  Russian  physi- 
cian, J.  W.  Troitzki,  in  1900.1 

Aphorisms  of  purely  pediatric  import  are  well  illustrated  in 
the  following  selections.  These  truths  are  so  apparent  that  they 
need  little  comment.  They  are  like  texts  which  have  been  amplified 
by  modern  research,  which  restate  old  truths  in  modern  termi- 
nology. The  aphorisms  dealing  with  nutrition  illustrate  this  well. 
The  greater  needs  of  the  sprightly  infant  are  just  now  being 
translated  into  terms  of  calories;  the  growing  schoolboy's  appe- 
tite is  proverbial,  that  he  needs  as  much  as  a  day  laborer  at  hard 
work  has  recently  been  determined  by  nutritional  studies!  We 
restate  the  old  truths  in  terms  of  modern  science.  Liquid  diets  for 

1  Troi'tzki,  J.  W.  Hippocrates  als  Kinderarzt,  Arch.  J.  Kinderb.,  Stuttg.,  1900, 
xxix,  223-247. 


2  PEDIATRICS  OF  THE  PAST 

febrile  disturbances  are  the  rule.  The  serious  import  of  convulsions 
in  febrile  diseases  continues  to  be  well  known.  Note  the  last 
aphorism  of  the  list,  a  brief  description  of  Pott's  disease. 

PEDIATRIC  APHORISMS  FROM  HIPPOCRATES 

Elderly  people  bear  fasting2  well;  infants  poorly,  especially  those 
of  lively  disposition  (i,  13). 

The  growing  organism  has  the  most  innate  (animal)  heat  and  there- 
fore requires  most  nourishment  (i,  14). 

Liquid  diet  is  proper  in  all  febrile  diseases,  particularly  in  children 
(i,  16). 

Treat  epilepsy  in  the  young  by  change  of  air,  of  environment  and 
mode  of  life  (ii,  45). 

Children  born  in  a  mild,  calm,  rainy  winter  or  a  cold  spring  are 
apt  to  be  puny  and  unhealthy  (iii,  12). 

Children  are  most  comfortable  and  healthy  in  spring  and  early 
summer  (iii,  18). 

The  diseases  of  the  newborn  and  of  infants  are  aphthae,  vomiting, 
insomnia,  night  fears,  inflammation  of  the  umbilicus,  and  discharges 
from  the  ears  (iii,  24). 

At  teething,  there  are  pruritis  of  the  gums,  convulsions  and  diarrhea, 
especially  when  cutting  the  canine  teeth,  and  in  fat,  constipated  infants 
(iii,  25). 

A  little  later,  there  are  tonsillar  affections,  crick  in  the  neck,  asthma, 
calculus,  round  worms,  warts,  scrofula,  tumors  about  the  ears  and 
elsewhere  (iii,  26). 

Approaching  puberty,  epistaxis  and  chronic  fevers  supervene  (iii,  27). 

Infantile  diseases  which  do  not  pass  away  at  puberty  become  chronic 
(iii,  28). 

Difficult  deglutition  and  suffocation  in  fever  without  swelling  of  the 
fauces  is  a  fatal  symptom  (iv,  34-35). 

In  fevers,  frights  or  convulsions  after  sleep  are  bad  symptoms  (iv,  67); 
stoppage  of  respiration  in  fevers  indicates  convulsions  (iv,  68). 

Epilepsy  before  puberty  may  change  for  the  better;  after  25  it  is 
usually  fatal  (v,  7). 

Acid  eructations  in  diarrhea  are  of  good  omen  (vi,  1). 

Those  who  acquire  a  gibbous  spine  with  cough  and  asthma,  before 
puberty,  die  (vi,  46). 

THE  DESCRIPTION  OF  MUMPS 

i.  In  Thasus,  about  the  autumnal  equinox,  and  under  the  Pleiades, 
the  rains  were  abundant,  constant,  and  soft,  with  southerly  winds;  the 
2 Galen  rightly  interprets  "fasting"  here  as  "spare  diet"  (Adams). 


HIPPOCRATES  3 

winter  southerly,  the  northerly  winds  faint,  droughts;  on  the  whole, 
the  winter  having  the  character  of  spring.  The  spring  was  southerly, 
cool,  rains  small  in  quantity.  Summer,  for  the  most  part,  cloudy,  no 
rain, .  the  Etesian  winds,  rare  and  small,  blew  in  an  irregular  manner. 
The  whole  constitution  of  the  season  being  thus  inclined  to  the  southerly, 
and  with  droughts  early  in  the  spring,  from  the  preceding  opposite  and 
northerly  state,  ardent  fevers  occurred  in  a  few  instances,  and  these  very 
r.nild,  being  rarely  attended  with  hemorrhage,  and  never  proving  fatal. 
Swellings  appeared  about  the  ears,  in  many  on  either  side,  and  in  the 
greatest  number  on  both  sides,  being  unaccompanied  by  fever  so  as  not 
to  confine  the  patient  to  bed;  in  all  cases  they  disappeared  without 
giving  trouble,  neither  did  any  of  them  come  to  suppuration,  as  is  com- 
mon in  swellings  from  other  causes.  They  were  of  a  lax,  large,  diffused 
character,  without  inflammation  or  pain,  and  they  went  away  without 
any  critical  sign.  They  seized  children,  adults,  and  mostly  those  who 
were  engaged  in  the  exercises  of  the  palestra  and  gymnasium,  but  seldom 
attacked  women.  Many  had  dry  coughs  without  expectoration,  and 
accompanied  with  hoarseness  of  voice.  In  some  instances  earlier,  and  in 
others  later,  inflammations  with  pain  seized  sometimes  one  of  the 
testicles,  sometimes  both,  some  of  these  cases  were  accompanied  with 
fever  and  some  not;  the  greater  part  of  these  were  attended  with  much 
suffering.  In  other  respects  they  were  free  of  disease,  so  as  not  to  require 
medical  assistance. 


SORANUS  OF  EPHESUS 

SECOND  CENTURY,  A.  D. 

IF  one  were  to  ask  a  schoolboy  in  a  psychanalytic  test  to  connote 
Ephesus,  he  doubtless  would  say  the  Temple  of  Diana;  a  clergy- 
man would  say  the  Epistle  of  Paul,  written  and  dispatched 
by  Tychicus;  while  a  medical  man  would  say  Soranus.  For  the 
fair  city  of  ancient  Asia  Minor  gave  Soranus  to  the  world.  There, 
and  later  at  Alexandria,  he  came  under  the  influence  of  Greek 
culture.  Little  is  known  about  him  except  that  he  settled  in  Rome 
between  1 10  and  130  a.  d.  Under  Trajan  and  Hadrian,  Rome  was 
a  city  to  live  in,  the  city  of  Plutarch,  of  Suetonius,  of  the  physician 
Aretaeus,  the  Cappedocian.  After  some  twenty  years  Soranus  was 
lost  track  of,  his  fate  is  a  mystery;  doubtless  acquiring  a  compe- 
tence or  even  a  fortune,  he  retired  to  some  Sabine  farm,  far  from 
the  Sturm  und  Drang  of  active  practice. 

He  was  a  good  observer,  a  clear  thinker,  a  medical  reformer, 
one  of  the  first  advocates  of  infant  welfare,  and  a  prolific  writer. 
He  is  credited  with  some  thirty  volumes,  of  which,  unfortunately, 
but  few  have  come  down  to  us.  He  wrote  on  gynecology,  obstetrics 
and  pediatrics.  He  wrote  well.  His  pediatric  writings  have  been 
enlarged  upon  by  Troitzki.  Garrison  states  that  in  obstetrics  no 
additions  of  value  were  made  until  the  time  of  Ambroise  Pare, 
fifteen  hundred  years  later.  Soranus  is  strikingly  modern:  he 
dealt  largely  in  real  facts,  things  which  will  be  just  as  true  in 
another  thousand  years  as  they  are  today. 

A  few  examples  will  testify  to  the  high  character  of  his  work. 

The  following  description  is  supposed  by  Leonard  Findlay 
to  refer  to  rickets,  and  well  it  may,  though  one  somehow  imagines 
that  such  a  careful  clinician  as  Soranus  would  have  given  a  fuller 
description,  but  the  omission  may  be  due  to  the  fact  that  he  was 
writing  on  the  care  of  infants  and  not  on  their  diseases. 

HOW  SHOULD  THE  CHILD  BE  TRAINED  IN  STANDING  AND  WALKING? 

When  the  infant  makes  attempts  to  sit  down  and  stand  up,  one 
must  assist  his  movements.  For  should  he  show  eagerness  to  sit  sooner 

4 


SORANUS  OF  EPHESUS  5 

than  is  right  or  too  often,  he  becomes  hunched,  owing  to  the  backbone 
bending  while  as  yet  the  body  has  no  sinews  to  resist  the  strain.  If  he 
continues  to  stand  up  with  growing  impetuosity,  and  wishes  to  walk 
about  his  legs  commonly  become  twisted  at  the  thighs. 

WHY  THE  MAJORITY  OF  ROMAN  CHILDREN  ARE  DISTORTED 

This  is  observed  to  happen  more  in  the  neighbourhood  of  Rome  than 
in  other  places.  Some  suggest  as  a  reason  that  the  city  is  undermined  by 
cold  waters  and  that  their  (i.e.  the  children's)  bodies  are  easily  chilled. 
Others  suggest  the  frequent  sexual  intercourse  of  women,  or  intercourse 
taking  place  after  a  drunken  bout.  The  truth  of  the  matter  lies  in 
inexperience  with  regard  to  the  rearing  of  children;  for  women  in  the  city 
have  not  so  great  a  love  for  their  children  as  to  have  regard  to  every 
particular  as  the  women  of  purely  Greek  stock  do.  If  no  one  oversees 
the  infant's  movements,  his  limbs  do  in  the  generality  of  cases  become 
twisted,  for  the  whole  weight  of  the  body  rests  on  the  legs,  and  the  floor 
or  pavement  on  which  he  walks  is  hard  and  unyielding,  being  for  the 
most  part  laid  with  stones.  When,  therefore,  he  rests  upon  a  hard  sub- 
stance, the  weight  pressing  on  the  limbs  is  great,  and  the  limbs  which 
bear  him  up  are  frail;  the  limbs  must  then  of  necessity  give  way  a  little, 
since  the  bones  are  not  yet  stiff.  Hence,  when  he  first  begins  to  sit  he 
must  be  propped  up  by  swathings  of  bandages  to  counterbalance  the  ills 
that  can  gain  the  mastery  over  him,  nor  must  he  sit  for  long  at  first.  As 
he  advances  farther  to  the  stage  of  creeping  and  standing  up  for  a  little, 
then  one  should  place  him  up  against  a  wall  and  leave  him  alone.  But  for 
purposes  of  making  him  approach,  use  a  chair  on  wheels.  Thus  from  a 
gradual  common  growth  of  all  the  members  he  will  practise  walking. 
So  much  for  movement. 

I.    NUTRITION    OF   THE    NEWBORN    INFANT 

After  the  infant  has  been  swaddled  and  cradled,  it  should  rest  and 
receive  no  food  at  least  for  the  first  two  days,  for  the  child  is  apt  to  be  in 
continual  motion  during  all  this  time  and  its  body  is  still  amply  provided 
with  nourishment  derived  from  the  mother,  which  it  must  first  have  time 
to  digest  before  it  is  ready  for  new  food.  The  case  is  altered  should  it 
develop  a  premature  appetite,  the  signs  of  which  I  will  explain  later. 
After  this  pause,  something  may  be  prepared  for  the  child  to  lick  up,  but 
never  butter,  which  is  difficult  to  digest  and  injurious  to  the  stomach 
....  For  this  purpose,  slightly  boiled  honey  is  much  more  to  be  recom- 
mended for  everything  raw  is  sharp  and  produces  flatulence;  but  things 
cooked  too  long  are  constipating  in  the  highest  degree,  and  what  is 
cooked  for  a  moderate  length  of  time  cleanses  the  stomach  and  the  intes- 


Sorani  EphesD 

Arte  obstetriciamorbisque  mulierum 

quae  supersunt 


Ex    apographo 

Friderici  Reinholdl  Dietz, 

Med.  et  Chir.   Dr. ,  Mediclnae  in  Arademia  Prussorura  Albertiaa 
Professor.  Ordioar.  t4c 

nuper    fato    perfnncti 
primuro   edita. 


M 


Regimontii    Prussorum 

»Q  Commissi*  apud  G  raef  iura  et  Unzerum. 
MDCCCXXXVIII. 

Title  page  of  Dietz'  edition  of  Soranus. 


SORANUS  OF  EPHESUS  7 

tines.  The  mouth  of  the  nursling  is,  therefore,  to  be  softly  stroked  with 
the  finger  after  which  Iuke-warm  honey  and  water  is  dribbled  into  it.  In 
this  way,  the  rich,  thick  material  is  diluted,  the  appetite  is  increased, 
since  the  child  will  recollect  the  pleasant  taste,  the  oesophagus  is  opened, 
the  digestion  of  food  proceeds  easily  after  the  canal  has  been  cleansed 
and  thus  the  whole  constitution  is  nourished.  (After  the  nursling  has  been 
cared  for  in  this  manner  for  these  two  days,  it  can  be  given  milk  on  the 
next  and  following  day  at  the  breast  of  a  good  wet  nurse.1)  During  the 
first  twenty  days  the  mother's  milk  is,  as  a  rule,  unfit  for  consumption 
by  the  child,  being  thick,  cheesy  and  difficult  to  digest. 

II.   THE  FINGERNAIL  AND  WATER  TESTS  FOR  MILK 

Whether  the  milk  will  coagulate  properly  is  determined  by  the  fact 
that  if  we  put  a  drop  on  the  fingernail  or  on  a  laurel  leaf  or  other  smooth 
surface  it  slowly  spreads  and  when  shaken,  retains  the  drop-form;  for  if 
it  flows  at  once  in  all  directions,  it  is  watery,  but  if  it  coheres  like  honey 
and  does  not  change  its  drop-form,  it  is  too  thick.  We  may  also  make  the 
test  by  adding  twice  as  much  water  to  a  given  quantity  of  milk;  the 
solution  will  then  take  place  only  after  a  considerable  time  and  the  white 
color  is  retained  to  the  last.  If  solution  takes  place  at  once  the  milk  is 
watery  and  it  can  be  used  still  less  if  it  forms  a  fibrous  coagulum  like 
that  of  serum.  In  such  a  condition  it  is  indigestible.  But  if,  after  some- 
time, it  does  not  diffuse  and  sinks  in  such  a  manner,  that  it  remains  at 
the  bottom  when  water  is  poured  on  it,  it  is  cheesy,  thick  and  soluble 
with  difficulty.2 

1  Soranus.  TcepiyvvaiKeiuv,  §31. 

2  Soranus.  Op.  cit.,  33. 


ARETAEUS,  THE  CAPPEDOCIAN 

SECOND  CENTURY,  A.  D. 

NEGLECTED  by  his  own  age  and  the  succeeding  barren 
centuries,  Aretaeus  waited  until  medical  history  became  a 
real  interest  for  proper  appreciation.  Now  he  emerges  as 
perhaps  nearer  the  Hippocratic  ideal  than  any  of  the  other  Greek 
authors.  Little  is  known  about  him.  He  is  supposed  to  have  been 
a  contemporary  of  Galen,  but  neither  mentions  the  other;  in  fact, 


Aretaeus,  the  Cappedocian. 

Aretaeus  is  scarcely  quoted  at  all  by  the  earlier  writers  but  has 
been  brought  to  modern  notice  by  Wigan  (1723),  by  Kiihn,  the 
Galen  scholar,  by  Francis  Adams,  his  translator,  and  by  William 
Osier. 

8 


ARETAEUS,  THE  CAPPEDOCIAN        9 

He  was  a  clear  thinker,  a  keen  observer  and  a  master  at 
clinical  description,  as  the  short  quotations  on  tetanus  and 
cholera  morbus  testify.  He  was  a  diagnostician.  His  clinical 
descriptions  are  satisfying  to  a  degree.  He  left  vivid  pictures  of 
many  diseases;  of  diphtheria,  empyema,  pneumonia.  He  was 
the  first  European  writer  to  give  a  real  account  of  diabetes. 
He  wrote  of  the  diseases  of  the  liver,  of  the  intestines,  of  the 
bladder.  Perhaps  best  of  all  are  his  contributions  to  nervous 
diseases.  He  studied  apoplexy  with  its  effects  on  intellect,  move- 
ment and  sensation,  the  cerebral  paralyses  and  the  paraplegias 
or  spinal  paralyses;  he  was  the  first  to  describe  the  decussation  of 
the  pyramids.  He  studied  insanity,  called  attention  to  the  aura  in 
epilepsy,  wrote  about  sciatica,  migraine,  and  hysteria  both  in 
women  and  men;  in  a  word,  he  was  doubtless  the  most  competent 
neurologist  of  his  age.  Max  Wellmann  shows  that  he  derived 
much  from  Archigenes  of  Apamea.  One  likes  to  think  differently 
and  imagines  the  old  Greek  as  a  lonely,  independent  thinker 
plodding  along  with  little  reference  to  the  opinion  or  work  of 
others. 

TETANUS  IN  CHILDREN 

Women  are  more  disposed  to  tetanus  than  men,  because  they  are  of 
a  cold  temperament;  but  they  more  readily  recover,  because  they  are  of 
a  humid.  With  respect  to  the  different  ages,  children  are  frequently 
affected,  but  do  not  often  die,  because  the  affection  is  familiar  and  akin 
to  them;  striplings  are  less  liable  to  suffer,  but  more  readily  die;  adults 
least  of  all,  whereas  old  men  are  most  subject  to  the  disease,  and  most  apt 
to  die;  the  cause  of  this  is  the  frigidity  and  dryness  of  old  age,  and  the 
nature  of  the  death.  But  if  the  cold  be  along  with  humidity,  these  spas- 
modic diseases  are  more  innocent,  and  attended  with  less  danger.1 

SEMEIOLOGY  OF  TETANUS 

In  all  these  varieties,  then,  to  speak  generally,  there  is  a  pain  and 
tension  of  the  tendons  and  spine,  and  of  the  muscles  connected  with  the 
jaws  and  cheek;  for  they  fasten  the  lower  jaw  to  the  upper,  so  that  it 
could  not  easily  be  separated  even  with  levers  or  a  wedge.  But  if  one,  by 
forcibly  separating  the  teeth,  pour  in  some  liquid,  the  patients  do  not 
drink  it  but  squirt  it  out,  or  retain  it  in  the  mouth,  or  it  regurgitates  by 
the  nostrils;  for  the  isthmus  faucium  is  strongly  compressed,  and  the 
tonsils  being  hard  and  tense,  do  not  coalesce  so  as  to  propel  that  which  is 
1  The  Extant  Works  of  Aretaeus,  Lond.,  1855,  p.  247. 


io  PEDIATRICS  OF  THE  PAST 

swallowed.  The  face  is  ruddy,  and  of  mixed  colours,  the  eyes  almost 
immovable,  or  are  rolled  about  with  difficulty;  strong  feeling  of  suffoca- 
tion; respiration  bad,  distension  of  the  arms  and  legs;  subsultus  of  the 
muscles;  the  countenance  variously  distorted;  the  cheeks  and  lips 
tremulous,  the  jaw  quivering,  and  the  teeth  rattling,  and  in  certain  rare 
cases  even  the  ears  are  thus  affected.  I  myself  have  beheld  this  and 
wondered.  The  urine  is  retained,  so  as  to  induce  strong  dysuria,  or  passes 
spontaneously  from  contraction  of  the  bladder.  These  symptoms  occur 
in  each  variety  of  the  spasms. 

But  there  are  peculiarities  in  each;  in  Tetanus  there  is  tension  in  a 
straight  line  of  the  whole  body,  which  is  unbent  and  inflexible;  the  legs 
and  arms  are  straight. 

Opisthotonos  bends  the  patient  backward,  like  a  bow,  so  that  the 
reflected  head  is  lodged  between  the  shoulder-blades;  the  throat  pro- 
trudes; the  jaw  sometimes  gapes,  but  in  some  rare  cases  it  is  fixed 
in  the  upper  one;  respiration  stertorous;  the  belly  and  chest  promi- 
nent, and  in  these  there  is  usually  incontinence  of  urine;  the  abdomen 
stretched,  and  resonant  if  tapped;  the  arms  strongly  bent  back  in  a 
state  of  extension;  the  legs  and  thighs  are  bent  together,  for  the  legs  are 
bent  in  the  opposite  direction  to  the  hams. 

But  if  they  are  bent  forwards,  they  are  protuberant  at  the  back, 
the  loins  being  extruded  in  a  line  with  the  back,  the  whole  of  the  spine 
being  straight;  the  vertex  prone,  the  head  inclining  towards  the  chest; 
the  lower  jaw  fixed  upon  the  breast  bone;  the  hands  clasped  together, 
the  lower  extremities  extended;  pains  intense;  the  voice  altogether 
dolorous;  they  groan,  making  deep  moaning.  Should  the  mischief  then 
seize  the  chest  and  the  respiratory  organs,  it  readily  frees  the  patient 
from  life;  a  blessing  this,  to  himself,  as  being  a  deliverance  from  pains, 
distortion,  and  deformity;  and  a  contingency  less  than  usual  to  be 
lamented  by  the  spectators,  were  he  a  son  or  a  father.  But  should  the 
powers  of  life  still  stand  out,  the  respiration,  although  bad,  being  still 
prolonged,  the  patient  is  not  only  bent  up  into  an  arch  but  rolled  together 
like  a  ball,  so  that  the  head  rests  upon  the  knees,  while  the  legs  and  back 
are  bent  forwards,  so  as  to  convey  the  impression  of  the  articulation  of 
the  knee  being  dislocated  backwards. 

An  inhuman  calamity!  an  unseemly  sight!  a  spectacle  painful  even 
to  the  beholder!  an  incurable  malady!  owing  to  the  distortion,  not  to 
be  recognized  by  the  dearest  friends;  and  hence  the  prayer  of  the  spec- 
tators, which  formerly  would  have  been  reckoned  not  pious,  now 
becomes  good,  that  the  patient  may  depart  from  life,  as  being  a  deliver- 
ance from  the  pains  and  unseemly  evils  attendant  on  it.  But  neither  can 
the  physician,  though  present  and  looking  on,  furnish  any  assistance, 
as  regards  life,  relief  from  pain  or  from  deformity.  For  if  he  should  wish 


ARETAEUS,  THE  CAPPEDOCIAN       u 

to  straighten  the  limbs,  he  can  only  do  so  by  cutting  and  breaking  those 
of  a  living  man.  With  them,  then,  who  are  overpowered  by  the  disease, 
he  can  merely  sympathize.  This  is  the  great  misfortune  of  the  physician.2 

CHOLERA  INFANTUM 

Cholera  is  a  retrograde  movement  of  the  materiel  in  the  whole  body 
on  the  stomach,  the  belly,  and  the  intestines;  a  most  acute  illness.  Those 
matters,  then,  which  collect  in  the  stomach,  rush  upwards  by  vomiting; 
but  those  humours  in  the  belly,  and  intestines,  by  the  passages  down- 
wards. With  regard  to  appearance,  then,  those  things  which  are  first 
discharged  by  vomiting,  are  watery;  but  those  by  the  anus,  liquid  and 
fetid  excrement  (for  continued  indigestion  is  the  cause  of  this  disease) ; 
but  if  these  are  washed  out,  the  discharges  are  pituitous,  and  then 
bilious.  At  first,  indeed,  they  are  borne  easily,  and  without  pain;  but 
afterwards  the  stomach  is  affected  with  retchings,  and  the  belly  with 
tormina. 

But,  if  the  disease  become  worse,  the  tormina  gets  greater;  there  is 
fainting;  prostration  of  strength  in  the  limbs,  anxiety,  loss  of  appetite; 
or,  if  they  take  anything,  with  much  rumbling  and  nausea,  there  is 
discharged  by  vomiting  bile  intensely  yellow,  and  the  downward  dis- 
charges are  of  like  kind;  spasm,  contractions  of  the  muscles  in  the 
legs  and  arms;  the  fingers  are  bent;  vertigo,  hiccup,  livid  nails,  frigidity, 
extremities  cold,  and  altogether  they  are  affected  with  rigors. 

But  if  the  disease  tend  to  death,  the  patient  falls  into  a  sweat;  black 
bile,  upwards  and  downwards;  urine  retained  in  the  bladder  by  the 
spasm;  but,  in  fact,  sometimes  neither  is  there  any  urine  collected  in 
the  bladder,  owing  to  the  metastasis  of  the  fluids  to  the  intestine;  loss 
of  utterance;  pulse  very  small,  and  very  frequent  in  the  cases  affected 
with  syncope;  continual  and  unavailing  strainings  to  vomit;  the  bowels 
troubled  with  tenesmus,  dry,  and  without  juices;  a  painful  and  most 
piteous  death  from  spasm,  suffocation,  and  empty  vomiting. 

The  season  of  summer,  then,  engenders  this  affection;  next  autumn; 
spring,  less  frequently;  winter,  least  of  all.  With  regard  to  the  ages, 
then,  those  of  young  persons  and  adults;  old  age  least  of  all;  children 
more  frequently  than  these,  but  their  complaints  are  not  of  a  deadly 
nature.3 

2  Aretaeus.  Op.  cit.,  pp.  247-249. 

3  Aretaeus.  Op.  cit.,  pp.  273-274. 


ORIBASIUS 

[325-403  A.  D.] 

ORIBASIUS  one  of  the  best  known  of  the  Byzantine  group  of 
physicians,  was  a  nobleman,  born  at  Pergamum,  in  Asia 
Minor,  educated  at  Alexandria  under  Zeno  of  Cyprus,  and 
settled  in  Constantinople,  dwelling  as  a  favored  child  of  fortune 
within  shadow  of  the  court.  Neuburger  says  of  him  that  "he 
caught  a  reflexion  from  the  setting  sun  of  antiquity."  Living  in 
affluence  as  the  body  physician  of  Julian  the  Apostate,  nephew  of 
Constantine  the  Great,  he  was  encouraged  to  undertake  an  ency- 
clopedia of  medical  and  other  knowledge  and  actually  compiled 
over  twenty  volumes.  Oribasius  was  no  original  worker,  but  we 
owe  a  great  debt  to  him  as  a  collector,  through  his  wide  reading  of 
the  best  of  the  ancient  writings.  In  many  instances  texts  are 
supplied  by  Oribasius  which  would  otherwise  have  been  lost  to 
posterity.  Later  in  life  he  contributed  numerous  volumes  of  his 
own  observations  and  methods  of  treatment,  some  written  for  his 
son  Eustathios,  a  student  of  medicine. 

Julian  the  Apostate  made  him  Quaestor  of  Constantinople. 
The  friendship  beween  the  Emperor  and  physician  lasted  until 
Julian  was  killed  on  his  Persian  expedition.  The  succeeding  rulers, 
Valens  and  Valentinian,  stripped  Oribasius  of  his  honors  and 
turned  him  over  to  "the  most  savage  of  the  barbarous  races," 
doubtless  the  Goths.  Instead  of  leading  a  life  of  hardship,  the 
physician  attained  great  popularity  among  the  barbarians,  so 
much  so,  in  fact,  that  he  was  called  back  to  Constantinople  where 
he  ended  his  days,  laboring  to  the  last  in  his  chosen  profession. 

Oribasius  was  what  would  now  be  called  a  general  specialist. 
He  touched  on  all  subjects;  naturally  he  included  pediatrics. 
His  "Synopsis"  includes  much  pediatric  writing.  The  second 
section  is  on  the  choice  of  nurses,  while  sections  five  to  thirteen 
deal  with  pediatrics  and  section  fourteen  is  devoted  to  the  educa- 
tion of  children.  To  quote  at  length  from  Oribasius  would  take 
us  too  far  afield.  One  example  must  suffice,  a  remarkable  state- 

12 


ORIBASIUS  13 

ment  about  the  education  of  children.  One  might,  not  unjustly, 
call  Oribasius  the  precursor  of  the  methods  of  Froebel  and  Mon- 
tessori.  Of  especial  interest  is  his  statement  concerning  the 
deterioration  of  the  body  from  lack  of  exercise  and  the  last  sen- 
tence on  the  subject  of  children's  nurses. 


ON  THE  HUMANE  UPBRINGING  OF  CHILDREN 

[From  Athenaeus] 

Infants  who  have  just  been  weaned  should  be  permitted  to  live  at 
their  ease  and  enjoy  themselves:  they  should  be  habituated  to  repose  of 
the  mind  and  exercise  in  which  little  deceptions  and  gaiety  play  a  part: 
their  diet  should  be  light  in  quality  and  moderate  in  quantity;  for  those 
who,  at  the  period  of  weaning,  stuff  them  with  food  and  endeavor  to 
give  them  rich  nourishing  foods  will  pervert  their  nutrition  and  prevent 
their  growth  from  the  very  weakness  of  their  natures.  Some  of  these 
children  will  be  affected  with  ulcerations  and  inflammations  of  the 
intestines,  with  procidentia  ani  and  with  grave  disease,  resulting  from 
the  frequency  of  indigestion  and  diarrhea.  After  the  sixth  or  seventh 
year,  little  girls  and  boys  should  be  confided  to  humane  and  gentle 
teachers:  for  those  who  attract  children  to  themselves,  who  employ 
persuasion  and  exportation  as  a  means  of  instruction  and  who  praise 
their  pupils  often,  will  succeed  better  with  them  and  will  do  more  to 
incite  their  zeal  to  studies:  their  instruction  will  rejoice  the  children  and 
put  them  at  their  ease.  Now,  relaxation  and  a  joyous  spirit  contribute 
much  to  digestion  and  favorable  nutrition ;  but  those  who,  on  the  other 
hand,  are  insistent  in  instruction,  who  resort  to  sharp  reprimands,  will 
make  the  children  servile  and  timorous  and  will  inspire  them  with  an 
aversion  for  the  objects  of  their  instruction :  it  is  by  beating  them  that 
they  expect  them  to  learn  and  recollect  things,  even  at  the  very  moment 
when  they  are  beaten,  when  they  have  lost  their  courage  and  presence  of 
mind.  It  is  not  necessary  either  to  torment  children  just  beginning  to 
learn  by  trying  to  teach  them  something  through  the  whole  length  of 
the  day:  on  the  contrary  the  greater  part  of  the  day  should  be  devoted 
to  their  games.  In  fact,  even  among  the  most  robust  people,  who  have 
already  reached  the  age  of  complete  development,  deterioration  of  body 
is  noticeable  in  those  who  have  applied  themselves  too  arduously  and 
without  interruption  to  the  pursuit  of  learning.  Children  of  twelve  years 
should  already  frequent  the  grammarians  and  geometers  and  exercise 
their  bodies;  but  it  is  necessary  that  they  should  have  preceptors  and 
supervisors  who  are  reasonable  and  not  entirely  devoid  of  experience,  so 
that  they  may  know  the  amount  and  proper  time  for  meals,  exercise, 


i4  PEDIATRICS  OF  THE  PAST 

bathing,  sleeping  and  other  details  of  personal  hygiene.  Most  people  will 
pay  a  high  price  for  grooms  for  their  horses,  choosing  for  this  purpose 
careful  and  experienced  men,  while  they  will  select  as  teachers  for  their 
children,  individuals  without  experience,  who  have  already  become  use- 
less and  incapable  of  rendering  any  of  the  ordinary  services  of  life.1 

1  Bussemaker  and  Daremberg.  Oeuvres  d'Oribase,  Paris,  1858,  111,  161-163. 


AETIUS  OF  AMIDA 

[502-575  A.  D.] 

A  ETIUS  of  Amida  (a  town  on  the  Tigris  in  Mesopotamia) 

/jV     attained  enduring  fame  chiefly  as  a  compiler.  Educated  at 

JljSL  Alexandria,  he  attained  preferment  at  the  Byzantine  court, 

doubtless  under  Justinian.  Besides  being  court  physician  he  was  an 

officer  of  the  guard  comes  obsequii. 

Experience  in  the  East  led  him  to  the  use  of  cloves  and  cam- 
phor. Aetius  was  a  compiler  of  no  mean  merit  and  we  are  indebted 
to  him  for  much  that  would  otherwise  have  been  lost.  In  many 
cases  his  excerpts  fill  in  the  omissions  or  lost  portions  of  Oribasius. 
Galen,  Moschion,  Rufus  of  Ephesus,  Leonides,  Soranus,  Philu- 
menus  are  among  those  referred  to  in  his  "Tetrabiblon"  in  sixteen 
volumes,  the  second  great  medical  compilation  of  the  Byzantine 
school,  but  esteemed  the  least. 

He  is  generally  regarded  as  the  first  eminent  physician  to 
embrace  Christianity  and  he  brought  into  his  writings  the  patter 
of  the  Church  in  medical  matters.  Kurt  Sprengel  quotes  some 
examples  and  almost  all  medical  historians  have  copied  these. 
In  making  a  certain  ointment  one  must  say  in  a  low  voice:  "May 
the  God  of  Abraham,  the  God  of  Isaac,  the  God  of  Jacob  deign 
to  give  this  medicine  virtue"  (i.e.,  make  it  efficacious).  Similar 
suggestions  were  carried  into  surgical  operations,  as  when  a 
foreign  body  lodged  in  the  pharynx  the  patient  should  be  touched 
on  the  neck  and  the  following  recited:  "As  Jesus  Christ  raised 
Lazarus  from  the  tomb  and  Jonah  from  the  whale,  thou  bone  or 
fragment  of  bone  likewise  come  forth. "  Or  this  may  be  used: 
"Come  up  or  go  down  the  Martyr  Blasius  and  the  servant  of 
Jesus  Christ  commands  you."  This  is  on  a  par  with  the  Christian 
surgeon  of  our  time  who  fell  on  his  knees  in  prayer  while  his 
patient  died  of  postpartum  hemorrhage,  and  of  the  dear  old  lady 
who  said  she  got  such  relief  and  comfort  from  repeating  that 
holy  and  biblical  word  "Mesopotamia." 

The  ophthalmological  writings  of  Aetius  are  generally  regarded 
as  the  best  of  antiquity,  although  he  does  not  mention  cataract. 

15 


1 6  PEDIATRICS  OF  THE  PAST 

Obstetrics,  gynecology,  surgery  are  all  fully  discussed,  and 
some  original  observations  and  methods  included,  though  for  the 
most  part,  he  followed  the  earlier  writers.  As  a  pediatrist  he 
chiefly  copied  the  old  manuscripts,  but  he  described  an  encepha- 
litis in  children,  also  a  form  of  epilepsy  or  convulsions  due  to 
disturbances  in  the  intestine  and  relieved  by  purging.  One  of  his 
pediatric  descriptions  must  suffice,  that  of  an  epidemic  of  diphtheria. 

In  children  the  complaint  is  developed  almost  constantly  from 
previously  existing  aphthae.  The  ulcers  are  at  times  white  and  patchy, 
at  others  of  an  ashen-grey  colour,  or  they  resemble  the  scabs  caused  by 
use  of  the  cautery.  The  patient  is  seized  with  dryness  of  the  throat,  to 
which  is  added  great  difficulty  in  breathing,  particularly  when  redness 
is  seen  under  the  chin,  or  if,  after  the  acute  stage  is  over,  noma  and 
gangrene  ensue  .  .  .  care  should  also  be  taken  of  the  fever,  which 
usually  sets  in  with  severity  ...  In  many  cases  the  uvula  is  destroyed 
and,  if  after  a  long  time  the  ulceration  stops  and  cicatrization  begins, 
children  speak  indistinctly  and  in  swallowing,  fluid  returns  through  the 
nose.  Thus  I  have  seen  a  girl  die  after  forty  days,  who  was  already  in 
convalescence.  Most  cases,  however,  are  in  danger  up  till  the  seventh 
day. 


PAUL  OF  AEGINA 

[625-69O  A.  D.] 

THE  last  important  product  of  the  great  school  of  Alexan- 
dria," as  Withington  styles  him,  was  Paul,  born  on  the  island 
of  Aegina  early  in  the  seventh  century.  Educated  in  Alexan- 
dria, he  practiced  there  for  many  years,  chiefly  as  surgeon  and 
obstetrician.  He  compiled  a  large  work  in  seven  volumes,  the 
first  of  which  was  devoted  to  dietetics  of  pregnant  women  and  of 


Paul  of  Aegina. 

children,  children's  diseases  and  other  subjects  pertaining  to 
hygiene.  He  disclaims  any  originality,  compiling  the  best  of  the 
earlier  writers,  Hippocrates,  Galen,  Leonides,  Soranus,  Antyllus 
and  others.  Neuburger  regards  him  highly,  believing  he  had  con- 
siderable independence  of  judgment  and  was  not  a  blind  follower 

17 


1 8  PEDIATRICS  OF  THE  PAST 

of  the  early  leaders.  His  works  were  soon  translated  into  Latin  and 
it  is  no  mean  tribute  that  two  hundred  years  after  his  death  they 
were  translated  into  Arabic.  His  original  descriptions  include 
lithotomy,  tonsillotomy  and  various  surgical  operations.  He  also 
wrote  military  surgery,  eye  surgery,  obstetric  operations  and  what 
not.  He  removed  the  testicles  when  he  operated  for  hernia,  a 
procedure  which  the  Arabians  followed. 

Paul  was  something  of  a  pediatrist,  but  one  must  content 
oneself  here  with  but  a  very  small  portion  of  what  he  offers. 
In  addition  to  the  quotation  given  below,  he  recommended  various 
applications  to  help  in  difficult  dentition  and  recommended 
decorticated  iris  roots  for  the  child  to  chew  on,  a  practice  much  in 
vogue  at  the  present  time.  He  used  baths  in  convulsions,  sup- 
positories or  honey  in  constipation,  and  classified  aphthae  into 
three  groups,  white,  red  and  black,  the  last  having  the  worst 
prognosis.  The  white  and  red  were  doubtless  different  forms  or 
stages  of  stomatitis  and  the  black,  diphtheria. 

ON  THE  ERUPTIONS  WHICH  HAPPEN  TO  CHILDREN 

Whatever  eruptions  appear  upon  the  skin  of  a  child,  are  to  be  encour- 
aged, in  the  first  place;  but  when  the  eruption  is  properly  come  out,  it 
may  be  cured  by  putting  the  child  into  baths  of  myrtle,  or  Ientisk,  or 
roses,  and  then  anointing  with  the  oil  of  roses  or  Ientisk,  or  with  a  cerate 
containing  ceruse.  And  its  body  may  be  gently  rubbed  with  nitre;  but  it 
will  not  bear  hard  friction.  But  a  very  good  plan  is  for  the  nurse  to  be  fed 
upon  sweetish  things.  And  the  child's  diet  ought  to  be  attended  to,  so 
that  it  be  neither  too  full  nor  too  spare.  If  the  child's  belly  be  constipated, 
a  little  honey  may  be  put  into  its  food;  and  if  even  then  it  does  not  obey, 
turpentine,  to  the  size  of  a  chick-pea,  may  be  added.  When  the  bowels  are 
loose,  millet,  in  particular,  ought  to  be  administered.1 

1  Adams,  F.  Paulus  Aegineta,  Lond.,  1844,  I,  10. 


RHAZES 

[852-932  A.  D.] 

ABU  BEKR  MUHAMMAD  BEN  ZAKHARIAH  ALRAZI, 
7j\  better  known  to  the  Occident  as  Rhazes,  born  at  the  little 
XjL  town  of  Raj  in  the  Persian  province  of  Khorassan,  was 
destined  to  become  the  glory  of  Arabian  medicine.  He  was  one  of 
those  wonderful  beings,  talented,  learned,  original,  generous,  a 
teacher  of  renown,  a  writer  with  few  equals  in  medicine  and,  as 
such,  is  classed  with  the  masters  of  clinical  description,  with  Hippo- 
crates, Aretaeus  and  Sydenham.  Rhazes  was  educated  far  above 
the  average  physician  of  his  time.  He  had  studied  philology,  music, 
mathematics  and  philosophy  before  he  devoted  his  time  to  medi- 
cine. His  greatest  work  is  "EI  Hawi"  or  "Continens"  (Content  of 
Medicine),  a  monumental  work  in  many  volumes  containing  the 
best  thought  of  the  Eastern  physicians  as  well  as  the  more  familiar 
ancients.  This  was  edited  after  his  death.  A  second  work  was 
dedicated  to  AI-Mansur  ibu  Ishak,  the  governor  of  Khorassan, 
"The  Kitab  al  tib  Almansuri"  (Book  of  Medicine  to  Almansur). 
Smallpox  had  indeed  been  mentioned  earlier,  but  Rhazes 
gave  the  first  real  description  of  it  together  with  measles,  which  he 
regarded  as  a  variety  of  smallpox.  He  ascribed  it  to  an  innate 
contagion  or  ferment  which  purifies  itself  sooner  or  later  and  is 
thrown  off  through  the  skin,  an  early  foreshadowing  of  the  present 
day  conception  of  germs  as  the  cause  of  infections.  His  style  is 
that  of  the  Arab,  the  sections  starting  with  quotations  from 
authorities:  "Ben  Messue  said,"  "Saracus  said,"  "Honain  said," 
and  winding  up  "I  say,"  or  "I  have  found."1  Rhazes  was  most 
successful  as  a  teacher  and  practitioner  and  lived  to  old  age,  only 
to  be  stricken  with  blindness,  while  his  constant  generosity  left 
him  in  poverty  and  doubtless  without  friends. 

Rhazes  observed  diseases  in  children,  wrote  about  them,  added 
definitely  to  our  pediatric  knowledge.  As  with  the  other  early 
writers,  a  brief  extract  must  suffice  here. 

1  Withington,  E.  T.  Medical  History,  Lond.,  1894. 

19 


20  PEDIATRICS  OF  THE  PAST 

SMALL-POX    IN   CHILDREN 

Now  the  Small-Pox  arises  when  the  blood  putrefies  and  ferments, 
so  that  the  superfluous  vapours  are  thrown  out  of  it,  and  it  is  changed 
from  the  blood  of  infants,  which  is  like  must,  into  the  blood  of  young 
men,  which  is  like  wine  perfectly  ripened:  and  the  Small-Pox  itself  may 
be  compared  to  the  fermentation  and  the  hissing  noise  which  take  place 
in  must  at  that  time.  And  this  is  the  reason  why  children,  especially 
males,  rarely  escape  being  seized  with  this  disease,  because  it  is  impos- 
sible to  prevent  the  blood's  changing  from  this  state  into  its  second  state, 
just  as  it  is  impossible  to  prevent  must  (whose  nature  it  is  to  make  a 
hissing  noise  and  to  ferment)  from  changing  into  the  state  which  happens 
to  it  after  its  making  a  hissing  noise  and  its  fermentation.  And  the 
temperament  of  an  infant  or  child  is  seldom  such  that  it  is  possible  for 
its  blood  to  be  changed  from  the  first  state  into  the  second  by  little 
and  little,  and  orderly,  and  slowly,  so  that  this  fermentation  and  hissing 
noise  should  not  show  itself  in  the  blood;  for  a  temperament,  to  change 
thus  gradually,  should  be  cold  and  dry;  whereas  that  of  children  is  just 
the  contrary,  as  is  also  their  diet,  seeing  that  the  food  of  infants  consists 
of  milk,  yet  it  is  nearer  to  it  than  is  that  of  other  ages;  there  is  also  a 
greater  mixture  in  their  food,  and  more  movement  after  it;  for  which 
reason  it  is  seldom  that  a  child  escapes  this  disease.2 

DIAGNOSIS  OF  SMALLPOX  AND  MEASLES 

The  eruption  of  the  Small-Pox  is  preceded  by  a  continued  fever,  pain 
in  the  back,  itching  in  the  nose,  and  terrors  in  sleep.  These  are  the 
more  peculiar  symptoms  of  its  approach,  especially  a  pain  in  the  back, 
with  fever;  then  also  a  pricking  which  the  patient  feels  all  over  his 
body;  a  fullness  of  the  face,  which  at  times  goes  and  comes;  an  inflamed 
colour,  and  vehement  redness  in  both  the  cheeks;  a  redness  of  both  the 
eyes;  a  heaviness  of  the  whole  body;  great  uneasiness,  the  symptoms  of 
which  are  stretching  and  yawning;  a  pain  in  the  throat  and  chest,  with 
a  slight  difficulty  in  breathing,  and  cough;  a  dryness  of  the  mouth, 
thick  spittle,  and  hoarseness  of  the  voice;  pain  and  heaviness  of  the 
head;  inquietude,  distress  of  mind,  nausea,  and  anxiety  (with  this 
difference,  that  the  inquietude,  nausea,  and  anxiety  are  more  frequent 
in  the  Measles  than  in  the  Small-Pox;  while,  on  the  other  hand,  the 
pain  in  the  back  is  more  peculiar  to  the  Small-Pox  than  to  the  Measles) ; 
heat  of  the  whole  body,  an  inflamed  colour,  and  shining  redness,  and 
especially  an  intense  redness  of  the  gums. 

When,  therefore,  you  see  these  symptoms,  or  some  of  the  worst  of 
them  (such  as  the  pain  of  the  back,  and  the  terrors  in  sleep,  with  the 

2  Rhazes.  Treatise  on  the  Small-pox  and  Measles,  trans.  byW.  A.  Greenhill,  m.  d., 
Lond.,  1848,  pp.  29-30. 


RHAZES  21 

continued  fever),  then  you  may  be  assured  that  the  eruption  of  one  or 
other  of  these  diseases  in  the  patient  is  nigh  at  hand;  except  that  there 
is  not  in  the  Measles  so  much  pain  of  the  back  as  in  the  Small-Pox;  nor 
in  the  Small-Pox  so  much  anxiety  and  nausea  as  in  the  Measles,  unless 
the  Small-Pox  be  of  a  bad  sort;  and  this  shows  that  the  Measles  come 
from  a  very  bilious  blood.3 

INFANTILE  DIARRHEA 

Infants  are  frequently  troubled  with  flux  of  the  bowels,  whether 
from  teething,  from  catching  cold,  from  spoiling  of  the  milk  by  choler 
(bile)  and  phlegm;  and  the  signs  of  choler  are  acidity  and  acridity  of  the 
stools,  which  are  rapidly  evacuated;  and  the  signs  of  cold  and  phlegm  are 
light-colored  stools,  griping  pains  in  the  abdomen  on  evacuation,  which 
is  instantaneous  unless  the  phlegm  (mucus)  be  viscid.4 

3  Rhazes.  Op.  cit.,  34-35. 

4  Rhazes.  De  aegritudinibus  puerorum,  cap.  xvi. 


FROM  THE  ANCIENTS  AND  ARABIANS  TO  THE 
MEDIEVAL  PEDIATRISTS 

A  S  is  well  known,  medical  authority  or  lore  came  down  to  the 
£\  medieval  physicians  chiefly  from  Greece  and  Rome  by  way 
xjL  of  the  Arabians  (using  the  term  in  a  comprehensive  sense) 
with  their  additions  and  suggestions;  a  vast  undigested  mass  of 
fact  and  more  fancy,  blindly  followed  for  what  the  medieval  mind 
thought  it  worth.  There  were  some  minor  Western  sources  as 
well.  This  SudhofF  has  shown  to  be  true  in  pediatrics  and  while 
the  authorities  quoted  came  to  western  Europe  by  way  of  the 
Eastern  translators,  commentators  and  observers,  at  least  two 
fragmentary  manuscripts  of  Western  origin  greatly  influenced 
late  medieval  pediatric  writing. 

Thus  SudhofF  regards  "Liber  de  passionibus  puerorum  Galeni" 
as  a  spurious  work,  not  by  Galen  but  written  or  compiled  between 
the  sixth  and  the  ninth  centuries.  This  Sudhoff  found  in  manu- 
script in  Prague  and  in  Florence.  It  begins:  "Ut  testatur  Ypocras 
in  afforismus,  pueris  noviter  genitis  multae  passionibus  emergunt, 
ut  tusses,  vomitus,  vigiline,  febres,  dyarrie,  tremores,  ventris  con- 
stipationes,  etc."  This  text,  Sudhoff1  believes,  had  a  wide  distribu- 
tion in  the  Middle  Ages  and  doubtless  influenced  both  practice  and 
teaching.     Its  origin  he  believes  to  be  the  writers  of  antiquity. 

Good  sense  is  shown  that  no  internal  medication  is  advised 
for  young  infants  except  in  epilepsy.  A  portion  of  the  text  is 
given  as  translated  by  Dr.  Herbert  F.  Wright  of  Washington. 

LIBER    DE    PASSIONIBUS    PUERORUM    GALENI 

As  Hippocrates  bears  witness  in  his  "Aphorisms,"  many  diseases  arise 
in  new-born  children,  such  as  coughs,  vomiting,  sleeplessness,  fevers, 
diarrhea,  convulsions,  constipation,  consumption  of  the  substantial 
humidity  and  the  like,  which,  on  account  of  the  tenderness  of  the  flesh, 
cannot  be  relieved  with  medicines  received  into  the  bodies,  but  it  is 
necessary  to  apply  suitable  remedies  to  all  the  aforementioned  places. 

1  Sudhoff,  K.  Janus,  xx,  443,  1915. 

22 


FROM  THE  ANCIENTS  AND  ARABIANS  23 

In  the  first  place,  whatever  be  the  child's  disease,  precaution  must 
be  enjoined  upon  the  nurse's  diet  and  so  exact  a  diet  must  be  observed, 
as  if  the  nurse  were  suffering  from  the  ailment  of  the  little  infant,  because 
the  milk  of  nurses  derived  from  contrary  foods  generates  an  ailment  in 
the  little  infants  heretofore  not  existing  and  aggravates  one  already 
found. 

If  the  child  or  infant  of  two  or  three  months,  more  or  less,  incurs  a 
cough,  the  nurse  should  diligently  avoid  all  salty  and  pungent  foods 
and  all  other  things  opposed  to  the  cough,  and  local  remedies  should  be 
applied  to  such  a  child.  The  breast  is  anointed  with  butter  and  dyalthea 
(diaiteon?) ;  then  powder  of  hyssop,  sage  and  origan  or  iris  and  calamint 
or  even  other  things  efficacious  for  cough  very  finely  ground  is  spread 
upon  the  breast  in  suitable  quantity,  and  after  a  moderate  amount  has 
been  spread  it  is  bound  with  a  woolen  bandage.  By  such,  and  similar 
things  according  to  your  inclination,  you  will  be  able  to  give  relief. 

If  it  suffers  vomiting,  make  the  following  plaster  and  place  upon  the 
forking  of  the  breast  and  on  the  throat: 

1$  mastiches,  olibani  et  pulverem  rosarum 

Distemper  with  juice  of  mint  and  mallows,  if  you  wish,  and  if  the  vomit- 
ing has  been  violent,  add  a  dash  of  vinegar. 

If  it  suffers  a  flow  of  the  bowels,  make  the  following  plaster: 

1$  bolum  armenicum,  corticem  mali  granati,  balaustiam 

and  make  a  confection  with  the  white  of  an  egg  and  with  the  juice  of  some 
styptic  herb  and  solatrum  and  arnogloss  and  place  upon  the  umbilicus, 
and  likewise  let  us  make  a  bath  of  styptic  herbs  and  make  the  child  sit 
therein  up  to  the  umbilicus. 
For  vomiting  of  children: 

1$  spicae 5i 

gariofili,  mastiches 5  semis 

boli  armenici 3  ii 

sandaracae 5  i 

nucis  muscatae 5  i 

Distemper  with  water  of  roses  and  apply  hot  to  the  stomach. 

Roelans,  the  author  of  the  third  pediatric  incunabulum,  refers 
frequently  to  a  little  book  on  the  diseases  of  children.  Following 
this  lead  SudhofF  made  a. search  of  the  various  libraries  and 
museums  and  unearthed  twelve  different  manuscripts,  some 
fragmentary,  in  Leipsic,  Oxford,  Cambridge,  the  Sloane  collection 
in  the  British  Museum,  the  Vatican  and  so  on.  These  differ  from 


24  PEDIATRICS  OF  THE  PAST 

the  "Passiones"  considered  above.  These  twelve  manuscripts 
and  the  Roelans  text  have  been  the  subject  of  a  critical  study  by 
Sudhoff,2  to  which  the  reader  is  referred  for  further  information. 
In  the  text  there  is  the  milk  test  usually  ascribed  to  Soranus; 
a  method  of  inducing  vomiting  by  tickling  the  fauces;  the  use 
of  external  applications  to  the  tibia,  to  the  abdomen,  to  the 
head  and  elsewhere,  so  let  us  look  complacently  today  at  the 
onion  poultice  to  the  wrists  and  ankles,  it  comes  of  ancient  line- 
age; baths  and  oil  rubs  are  of  great  value  and  too  much  fallen 
into  disuse. 

INCIPIT    PRACTICA     PUERORUM    PASSIONES    PUERORUM    ADHUC    IN 

CUNABULIS    IACENTIUM    (DISEASES    OF    CHILDREN   STILL 

IN    THE    CRADLE) 

I  have  decided  to  treat  in  brief  compendium  the  sufferings  of  children 
still  lying  in  the  cradle  and  to  assign  remedies  for  the  individual  infirmi- 
ties. The  first  question  for  consideration,  therefore,  is  the  milk  upon 
which  the  child  is  nourished,  whether  it  be  good,  and  this  is  determined 
as  follows.  For  it  should  be  good  and  of  good  odor  and  continuous,  and 
this  we  learn  in  the  following  manner.  Let  the  milk  be  placed  upon  a  rock 
or  polished  sword;  if  it  stands  after  the  manner  of  a  crystal,  it  is  good, 
but  if  after  the  manner  of  water,  it  is  not  good,  and  it  is  not  necessary 
that  the  nurse  shake  the  child's  kidneys  violently  beforehand. 

If  the  nurse  has  no  milk,  let  her  eat  seed  of  fennel,  lettuce  and  cumin, 
ginger  and  long  and  white  pepper. 

Note  that  everything  which  increases  the  milk  increases  the  sperm 
and  vice  versa. 

If  they  suffer  fissure  of  the  lips  because  of  excessive  hardness  or 
flesh  of  the  breasts,  the  cure  is  as  follows:  Take  well-combed  wool 
and  dip  in  the  juice  of  lanceolate  plantain  and  butter  or  fresh  hen  fat  and 
with  this  warmed  and  with  these  juices  smear  the  lips  with  a  feather. 

If  it  suffer  insomnia,  make  fomentations  of  cool  herbs,  such  as 
mallows,  lanceolate  plantain,  solatrum,  and  anoint  with  populeon, 
oil  of  roses  and  violets  mixed  together  and  juice  of  mandragora,  purs- 
lane and  lettuce.  In  all  these  dip  a  cloth  and  place  it  upon  the  forehead 
and  temples.  Likewise  anoint  the  forehead  and  temples  with  oil  of 
violets  mixed  with  woman's  milk  or  with  oil  of  roses. 

If  the  child  suffer  vomiting,  make  a  plaster  of  the  meal  of  wheat 
bread  dipped  first  in  vinegar  and  yolks  of  roasted  eggs,  mastic,  gum 
arabic,  incense;  temper  them  with  mint  juice  and  a  little  vinegar  and 

2  Sudhoff,  K.  Janus,  1909,  xiv,  467. 


FROM  THE  ANCIENTS  AND  ARABIANS  25 

place  this  plaster  upon  the  mouth  of  the  stomach  and  place  a  crust  of 
toasted  bread  at  the  nostrils. 

If  you  wish  to  induce  vomiting,  press  down  the  child's  tongue 
with  the  finger,  moderately,  lest  you  hurt  him,  or  place  a  hen's  feather 
dipped  in  oil  back  as  far  as  the  palate  in  the  throat. 

If  he  suffer  looseness  of  the  stomach,  make  constrictives  as.  barley 
meal  with  juice  of  arnogloss  or  centinodia  or  pulicaria  with  a  little  vine- 
gar or  egg  albumen,  temper  with  addition  of  powder  of  roses,  mastic, 
incense,  bolus  armenicus,  sandarach,  acacia,  wormwood,  balaustia  and 
the  like.  For  an  extreme  case,  boil  roses  in  water  and  let  him  sit  in  this 
water  and  make  fomentations  on  the  tibiae  and  the  feet.  Likewise  take 
two  parts  of  consolida  major  and  one  part  of  plantain  or  Iaureola, 
temper  the  earth  in  the  juice  of  herbs  and  make  like  a  plaster  by  soften- 
ing between  the  hands  and  place  it  upon  the  umbilicus. 

If  he  suffer  excessive  constipation,  make  a  suppository  of  honey  and 
salt.  Likewise  cut  the  root  of  a  leek  into  four  parts  by  removing  the 
barbs  and  upon  each  part  place  three  grains  of  salt  and  apply,  or  make 
a  mollifying  injection  for  him  or  take  the  shell  of  a  nut  and  fill  it  with 
butter  and  place  upon  the  umbilicus  (after  the  entire  stomach  has  been 
smeared  with  the  same  butter)  or  the  intestines  of  a  breeding-sow,  which 
is  better. 

If  he  have  a  fever,  take  a  little  barley  ground  with  violet  and  temper 
this  meal  with  juice  of  wormwood,  mallows,  plantain  and  navel  wort 
and  make  a  plaster  and  place  it  upon  the  little  fork  of  the  breast. 

Now  if  the  child  be  too  thin  and  delicate  and  weak,  so  that  he  has 
nothing  but  skin  and  bones,  prepare  for  him  the  following  bath.  Take 
an  old  capon  and  sheep's  feet,  boil  for  a  long  time  in  water,  so  that 
the  flesh  is  separated,  and  in  this  water  bathe  the  infant.  And  after  he 
is  taken  out  of  the  bath  smear  him  with  the  following  ointment.  Take 
butter,  new  wax,  crude  ram's  tallow  and  oil  and  liquefy  all  and  filter,  and 
with  this  ointment  smear  from  the  sole  of  the  foot  up  to  the  head.  In  the 
aforementioned  bath  bathe  him  daily  for  a  week  and  he  will  become  very 
fat. 

If  because  of  the  saltness  of  the  urine  and  softness  of  the  flesh  he 
suffer  excoriation  and  heat  around  the  legs,  sprinkle  the  place  with  wheat 
meal  well  tritonized  or  with  powder  of  roses  not  too  fine. 

If  he  has  slippery  worms  in  his  stomach,  take  the  juice  of  wormwood 
and  pulp  of  coloquintida  and  ox  gall  and  apply  to  the  umbilicus  as  hot 
as  can  be  borne. 

If  he  has  become  bloated  throughout  the  body  or  in  a  part,  take  the 
tips  of  the  elder  and  dwarf-elder  and  boil  in  white  wine  and  wrap  the 
child  in  a  cloth  dipped  in  this  wine  warmed,  either  his  entire  body  or 
the  part 


26  PEDIATRICS  OF  THE  PAST 

If  he  suffer  pain  in  his  gums  either  on  account  of  excoriations  or  on 
account  of  growing  teeth,  take  the  juice  of  plantain  or  the  bark  of  the 
dwarf-elder  and  place  in  his  mouth  or  smear  with  hare's  brains. 

If  he  have  a  cancer  in  his  mouth  or  elsewhere,  take  the  powder  of 
burnt  deer's  horn  and  the  bark  of  pomegranate  and  sprinkle  thereon. 

If  he  be  afflicted  with  stone,  take  powder  of  burnt  scorpion  and  goat's 
blood  and  place  upon  the  breast. 

If  he  be  epileptic,  give  him  peony  grass  with  woman's  milk  to  drink 
or  suspend  from  his  neck  and  let  him  drink  the  curdled  milk  of  a  hare. 

If  he  does  not  have  good  vision,  place  the  juice  of  hasta  regia  in  his 
eye.  But  note  that  there  is  one  which  bears  a  saffron  flower  and  is  bene- 
ficial to  males,  another  which  bears  a  hyacinth  flower,  beneficial  to 
females.3 

3  Translated  from  the  Latin  text  as  emended  by  Karl  Sudhoff. 


w 


THE  PEDIATRIC  INCUNABULA 

ITH  the  flood  of  books  which  followed  soon  after  the 
introduction  of  printing,  there  were  four  which  had  to  do 
with  diseases  of  children.  Two  of  these  were  published 
separately  as  books  on  diseases  of  children.  The  third  was  evidently 
printed  with  some  other  material  long  since  lost,  while  the  fourth 
was  simply  part  of  a  long  poem  dealing  with  health  and  related 
subjects.  The  first  is  the  work  of  Bagellardus;  the  second,  Met- 
Iinger;  the  third,  Roelans  and  the  fourth,  Louffenburg.  The  last- 
named  work  was  written  in  1429  but  not  printed  until  nearly  the 
end  of  the  same  century  .These  four  works  have  a  peculiar  interest, 
for  with  their  appearance  opinions  about  the  diseases  of  children 
began  to  take  more  definite  form  and  from  this  time  on  the  develop- 
ment of  pediatrics  may  be  traced  very  definitely.  There  is  more 
in  these  books,  especially  Metlinger's,  than  appears  from  a  casual 
perusal.  Do  not  laugh  at  the  ideas  of  disease  or  at  the  therapeutics, 
some  of  which  are  sound.  There  is  of  course  much  that  is  foolish 
and  stupid,  but  so  there  is  now,  and  there  are  countless  current 
publications  which  will  in  the  future  seem  just  as  foolish,  and 
indeed,  to  the  student  of  medical  history  they  do  today.  The 
Louffenburg  item  contains  what  we  believe  to  be  the  earliest  illus- 
trations used  in  connection  with  the  diseases  of  children. 


PAULUS  BAGELLARDUS 

[?-I492] 

PRINTING  developed  rather  rapidly  in  Italy  whither  it  had 
been  carried  in  1465  by  Sweynheym  and  Pannartz.  Scarcely 
seven  years  elapsed  before  the  first  printed  book  on  the 
diseases  of  children  appeared  at  Padua  from  the  press  of  Bartho- 
Iomaus  de  Valdezocchio  and  Martinus  de  Septem  Arboribus.  The 
book  is  numbered  2244  by  Hain  and  it  is  dated  April  21,  1472. 
Sudhoff  gives  the  interesting  features  as  follows: 

Incipiunt  capitula  secundi  libri.  //  C.  I.  de  saphati  fauositate  & 
eius  cura.  //  .  .  [BI.  3r:]  AD  ILLVSTRISSIMVM  PRINCIPEM 
DOMINVM  NICOLA  //  VM.  TRVNO  DIGNISSIMVM.  //  DVCEM 
VENETIARVM  DO  //  MINVM  SWM  PRECIPWM  //  LIBELLVS 
DE  EGRITVDINI  //  BVS  INFANTIVM  PER  MAGI  //  STRVM 
PAVLVM  BAGELLAR  //  DVM  A  FLVMINE  EDITVS  IN  //  CIPIT 
FOELICITER.  [BI.  6r  Ziele  11:]  INCIPIT  PARS  SECVNDA.  DE. 
//  EGRITVDINIBVS.  [BI.  4or  Zeile  15]  m.  cccc.  lxxii  die  xxi  Aprilis. 
//  BAR  VAL  patauus  F.  F.  //  MAR  de  septem  arboribus  prutenus. 

The  second  edition,  Hain  2245,  is  dated  November  10,  1487, 
and  Mr.  Charles  Perry  Fisher  gives  the  dedication  and  signature 
as  follows: 

[F.  ia:]  AD  Illustrissimum  principem  do  //  minum  NicoIau[m] 
Tronu[m].  dignissimu[m]  //  ducem  Ueneciarum  dominu[m]  suu[m] 
p[rae]  //  cipuu[m].  ***  [F.  21b:]  Finit  per  b[r]eue  opusculum  de 
infantiu[m]  //  infirmitatibus  redediisq[ue]  ea[rum].  Editu[m]  per 
egregium  ac  famosissimum  artiu[m]  [et]  medicine  docto[r]e[m] 
m[a]g[ist]r[u]m  Paulu[m]  bagel  //  Iardu[m]  a  flumine:  [et]  imp[re]ssus 
die.  10.  noue[m]bris.  p[er]  p.  matheu[m]  [de]  vindischg[r]etz.  1.  4.  8.  7. 

In  the  National  Neapolitan  Library  there  is  a  third  incuna- 
bulum  in  Italian,  translated  by  an  unknown  Brescian  and  printed 
in  i486.  This  edition  though  dated  does  not  bear  any  place. 
Reichling1  gives  the  folowing  details:  414.  Bagellardus  a  Flumine, 

1  Appendices  ad  Hainii-Coppingri  Repertorium  bibliographicum  additiones  et 
emendationes.  Fasciculus  2,  Monachii  1909. 

28 


PAULUS  BAGELLARDUS  29 

Paulus.  Libellus  de  infantum  aegritudinibus  ac  remediis,  italici. 
S.  I.  et  typ.  n.  i486,  a  di  Marzo.  In  40;  char.  rom.  rud.  et  inaequaL; 
i6ff  non  num.,  sign  a  et  b;  36  1 1. 

F.  1  a  Alio  illustrissimo  principe  Nicalao  trono  di  Venetia  duca  di-// 
gnissimo  Iibreto  singular  de  tutte  Ie  malatie  dal  nascimento  fina  // 
anni  siete  per  miastro  Paulo  balbiebardo  da  flume  composto  //  e  de 
latino  per  uno  medico  bressiano  a  commune  beneficio  uul  //  gar  facto.  // 
Fi6b  Opeti  deli  egritudini  e  remedii  de  fatolini  cu  altri  tati  capituli:  // 
per  il  famossissimo  &  egregio  deli  arte  e  medicina  doctore  maistro  // 
Paulo  balgielardo  da  fiume  coposto  felicemete  Iiure  (sic)  //  a  di  xvi 
Marzo  m.ccc.  Ixxxvi  per  uno  bresano  a  complitientia  //  de  molte  done  in 
uulgare  traducta  //  Finis  // 

This  book,  the  first  of  the  pediatric  incunabula,  as  we  have 
just  seen,  was  entitled  "Libellus  de  egritudinibus  infantium" 
and  bears  the  date  of  1472.  It  was  written  years  before  by  Paulus 
Bagellardus  a  Flumine,  as  his  name  is  usually  given.  In  the  dizain 
of  Claude  Malet,  in  the  reprint  of  Toletus,  the  author  is  called 
Bagaldus  a  fluvio,  but  in  the  text  which  follows  the  other  appella- 
tion is  used.  There  is  some  doubt  as  to  the  meaning  of  the  words 
added  to  the  name,  which  also  appear  as  Flumene  or  Fiume. 
Simonini  states  that  Cagna  mentions  a  family  of  the  same  name 
as  the  author,  which  came  from  Fiume.  This  family  flourished  in 
Padua  in  earlier  years.  Researches  made  at  Fiume  did  not  reveal 
any  such  name  so  that  the  Flumina  or  Flumene  either  refers  to 
some  other  place  or,  what  is  more  likely,  as  Simonini  suggests, 
the  name  was  added  because  Bagellardus  lived  on  the  river 
which  flows  through  the  town. 

The  date  of  his  birth  is  not  known  but  he  was  educated  at 
Padua,  where  he  studied  philosophy  and  medicine.  He  practiced 
medicine  in  the  same  city,  taught  medicine  for  twenty-eight  years 
as  docent,  for  two  as  ordinarius  and  he  then  was  made  professor 
of  medicine.  He  seems  to  have  enjoyed  the  confidence  of  the 
people  and  of  the  rulers  both  in  Padua  and  later  in  Venice  as  he 
was  frequently  consulted  on  important  matters.  After  thirty  years 
in  Padua  he  became  tired  and  moved  to  Venice,  but  the  climate 
did  not  agree  with  him  so  he  returned  to  his  old  home  where  he 
died,  according  to  some  in  1492,  according  to  others  in  1494.  He 
was  interred  in  the  portico  of  Saint  Anthony's  and  in  1584  his 
mausoleum  was  restored. 


unguentu  factum  ex  ungucto  cerufelote 
cu  oleo  ro£.&  litargiro  auri  mirabiliter  tollic 
Sed  breue  quodam  adderc  intendo.  Q£  8i  ft 
jpuu  fit  8C  minimu  eft  taracn  uirtutis  amplu 
non  folum  in  infantibus  ladlacium  excori' 
ationibus  ♦imo  etia  in  nutricibus  habetibus 
fci(Turam  cxtrcmitatum  papillaru  •  Q^uod 
cdtalc-Ri-faritieamidi  j.£aque  rokquatu 
fufficit  .  ad  infpiflatione  &c  fiat  linimentu  . 

Opufculu  de  cgritudinibus  &  remediis  lfi' 
tium  ac  totidcm  capitulis  cdpilatu  p  egregiu 
ac  famofiflimu  araum  &  medicine  dottore 
magiftrum  Paulum  bagcllardum  a  flumic 
fochciter  explicit . 


Sola  miferia  caret  inuidia 

MXXCC.LXXIIdiexxi  Aprili*  • 

BAR  VAL  ptantis  F-R 

MAR  de  fepteiu  arboribus  pruteniw 

Last  page  of  the  first  edition  of  Bagellardus  showing  the  printer's  signature. 


PAULUS  BAGELLARDUS  31 

The  book  is  inscribed  to  Nicolo  Tron,  who  was  made  Doge  of 
Venice  in  1471  and  who  died  in  1473,  which  fixes  the  date  of  the 
book  pretty  well.  The  book  was  reprinted  in  1487  and  in  1538 
Master  Petrus  Toletus  issued  another  edition  printed  at  Lyons 
with  the  title  of  "Opusculum  recens  natum  de  morbis  puerorum 
cum  appendicibus  magistri  petri  Toleti  ex  Professo  Medici." 
Of  this  more  later. 

Bagellardus  is  mentioned  by  the  earlier  medical  historians  and 
bibliographers,  but  that  is  all.  In  1909  the  indefatigable  Sudhoff2 
gave  a  short  account  of  Bagellardus  and  his  book  in  connection 
with  his  study  of  the  work  of  Roelans.  A  few  years  later  Apert, 
searching  through  the  boxes  of  books  along  the  Seine,  found  a 
copy  of  the  Toletus  reprint  and  wrote  an  account  of  it.3  Still  more 
recently  R.  Simonini  of  the  department  of  pediatrics  and  also  of 
the  history  of  medicine  of  the  University  of  Modena4  published 
his  researches  into  the  life  and  work  of  Bagellardus  together  with 
an  account  of  the  contents  of  each  chapter.  The  translation  pub- 
lished here  is  the  first  rendition  into  English  and  doubtless  the 
first  complete  translation.  It  was  made  for  the  editor  by  Dr. 
Herbert  Francis  Wright  of  Washington,  who  has  accomplished 
a  difficult  task  as  the  book  is  written  in  medieval  Latin,  freely 
interspersed  with  other  words  of  local  origin.  The  text  as  given 
by  Toletus  was  used. 

Bagellardus  must  have  been  well  read  in  the  classics  for  he 
refers  to  Hippocrates,  Avicenna,  Isaac,  Rhazes,  Averroes,  Mesue 
and  others.  He  made,  as  it  were,  a  compendium  of  pediatric 
opinions,  but,  of  course,  it  also  expressed  what  he  believed  to  be 
the  best  practice  of  the  time;  a  curious  mixture  of  sense  and 
nonsense,  good  and  bad,  like  so  many  books  of  the  present  day. 
Medicine  was  still  a  matter  of  authority  rather  than  research 
and  what  was  written  was  regarded  as  the  truth.  The  work  is 
divided  into  two  parts:  the  first  is  on  the  management  of  infants 
in  the  first  months;  the  second  is  in  twenty-two  chapters,  which 
in  the  edition  of  Toletus  are  each  followed  by  an  appendix  by 
that  worthy  writer. 

Of  Toletus  we  know  comparatively  little  but  he  may  well  be 
considered  here.  He  was. born  in  1502,  studied  in  Montpellier 

2  Sudhoff,  K.  Janus,  Amsterdam,  xiv,  467,  1909. 

3  Apert,  E.  Arch,  de  med.  d.  enf.f  Paris,  xi,  26,  1912. 

4  Simonini,  R.  Med.  ital.,  Milano,  11,  124,  176,  192 1. 


32  PEDIATRICS  OF  THE  PAST 

where  he  and  Rabelais  were  friends  together;  later  he  settled  in 
Lyons  where  he  was  a  physician  to  the  Hotel  Dieu.  Later  he  became 
physician  to  Charles  ix  and  Henri  in  and  of  Catharine  de'Medici. 
In  the  plague  epidemics  of  1564  and  1567  he  rendered  wonderful 
service  to  the  city  of  Lyons.  He  edited  the  work  of  Paul  of  Aegina, 
translated  a  work  of  Galen  on  tumors,  which  was  published  at 
Lyons  in  1552  with  the  title  "Des  tumeurs  outre  Iecoutumier  de 
nature,"  and  wrote  some  polemics,  but  his  chief  work  as  an  author 
was  his  appendices  in  his  edition  of  the  work  of  Bagellardus. 
The  "  Opusculum"  has  two  interesting  poems  preceding  the  text : 

OCTOSTICHON  EJUSDEM 

Sex  ego  cum  tenebris  perducens  lustra  profundis, 

arridet  speculo  nex  mea  forma  Ievis. 
SoIIicitor,  crebris  nee  cesso  membra  movere 

gressibus,  et  Iacrymis,  Iumina  nigra  rigo. 
Efficit  hoc  Erato,  quae  semper  cogit  amare 

indomita  hac  angor,  semper  ineptus  amor. 
Ite  alio  ignes,  ite  hinc,  nulla  occasio  Iucri  est, 

fida  mihi  custos  addita  pauperies. 

(Six  lustra  have  I  passed  in  shades  profound; 
No  more  my  slender  form  a  smile  reflects. 
Upwrought,  I  ever  pace  with  quickened  step 
And  flood  the  burnt  out  torches  with  my  tears — 
'Tis  due  to  her,  who  e'er  my  love  compels, 
Herself  unmoved;  I  pine  with  love  that's  vain! 
Depart,  ye  fires,  begone,  no  chance  for  gain 
Where  poverty  my  faithful  guardian  is!5) 

CLAUDIUS     MALETUS     BURGENSIS      APUD      SEGUSIANOS       LECTORI, 

DECASTICHON 

Hactenus  infantes  multi  periere  dolore 

ignoto,  haud  aderat  qui  dare  posset  opem. 
Obstetricis  adhuc  matris  simul  atque  nutricis 

non  medicus  quae  sint  scripserat  officia. 
Nee  mirum,  res  dura  nimis,  vix  cognita  doctis, 

ista  sed  a  fluvio  scripta  Bagaldus  habet. 
Haec  ornat  scholiis  Petrus  ToIIetus  opimis, 

doctius  his  nemo  scribere  crede  potest. 
Hoc  erne  quicumque  es  lector  peramande  volumen, 
infantum  si  vis  corpora  sana  fore. 
6  Both  metrical  versions  are  by  Dr.  Herbert  F.  Wright. 


PAULUS  BAGELLARDUS  33 

A  DIZAIN  TO  THE  READER  BY  CLAUDE  MALET  OF  BOURG-EN-BRESSE 

Till  now  full  many  a  babe  from  unknown  ill 

Hath  died  with  none  at  hand  prepared  to  aid. 

No  doctor  until  now  the  many  cares 

Of  midwife,  nurse  or  mother  hath  described. 

Nor  strange;  the  subject's  difficult,  the  wise 

E'en  find  it  so;  this  Bagellardus  did. 

Petrus  Toletus  hath  enriched  the  work 

With  learned  notes,  which  none  could  better  do. 

Whoe'er  you  be,  dear  reader,  buy  this  book, 

If  you  would  have  the  infant's  body  sound. 

Apert  believes  that  the  first  verse  shows  that  Toletus  had  some 
chronic  trembling  disease  which  was  attributed  to  worshiping  too 
assiduously  at  the  shrine  of  love. 

Very  little  of  Toletus  need  be  given.  Appended  to  the  Bagel- 
lardus text  will  be  found  what  may  be  regarded  as  the  most 
important  part  of  his  book,  his  own  consideration  of  diseases  not 
mentioned  by  Bagellardus.  Bound  in  the  same  volume  are  several 
letters  and  other  writings  of  no  pediatric  interest. 

Bagellardus  considers  the  care  of  the  infant  during  the  first 
month  and  then  devotes  the  remainder  of  the  work  to  the  various 
diseases.  He  would  have  been  a  disciple  of  that  wise  man  who  said : 

Be  not  the  first  by  which  the  new  is  tried, 
Nor  yet  the  last  to  lay  the  old  aside. 

He  said:  "But  because  in  our  times  the  doctor  must  act 
not  according  to  rules,  but  at  times,  however,  not  totally  in 
opposition  to  the  rules,  etc."  The  leaven  of  the  Renaissance  was 
beginning  to  work.  In  all  ages  physicians  have  confused  post 
hoc  and  propter  hoc.  Bagellardus  would  have  been  a  fine  writer  of 
testimonials  for  a  modern  advertising  drug  firm.  Speaking  of 
conclusions  he  says:  "Yet  I  know  from  experience  that  I  have  seen 
many  infants  so  stiff  that  they  could  not  be  bent  upward  or  down- 
ward who,  by  the  mere  application  to  the  spondyles  of  the  neck 
of  oil  of  white  lilies  or  wet  hyssop,  are  relieved  and  cured  by  the 
favor  of  the  Lord  from  such  a  contraction."  A  few  hundred  years 
from  now  some  one  will  be  smiling  at  the  present-day  claims  of  the 
cure  of  epilepsy  with  snake  venom  and  by  mixed  glands. 

Speaking  of  glands  read  the  chapter,  "On  Incontinence 
of  Urine  and  Bed  Wetting." 


34  PEDIATRICS  OF  THE  PAST 

But  enough,  the  reader  will  require  little  comment  on  the 
following  text: 

Part  I 

ON  THE  CARE  OF  INFANTS  DURING  THE  FIRST  MONTH 

When  the  infant  at  the  command  of  God  emerges  from  the  womb, 
then  the  midwife  with  eager  and  gentle  hand  should  wrap  it  up  in  a  linen 
cloth  which  is  not  rough,  but  rather  smooth  and  old,  and  place  it  on  her 
lap,  noting  whether  the  infant  be  alive  or  not  or  spotted,  i.e.,  whether 
black  or  white  or  of  bluish  color  and  whether  it  is  breathing  or  not. 
If  she  find  it  warm,  not  black,  she  should  blow  into  its  mouth,  if  it  has 
no  respiration,  or  into  its  anus;  but  if,  as  sometimes  happens,  the  anus  is 
closed  by  a  little  skin,  she  should  cut  it  with  a  sharp  knife  or  hot  gold 
thread  or  some  similar  instrument.  If  the  infant  is  alive  and  of  bluish 
color,  then  she  should  cut  the  umbilicus  or  umbilical  vein,  letting  it  out 
to  four  fingers  in  length  and  tying  it  with  the  twisted  cord  itself  or  with 
twisted  wool  or  silk,  yet  with  a  loose  knot,  lest  the  infant  suffer  pain. 
And  thus  you  allow  it  to  stay  until  the  fall  or  consolidation  of  the  umbili- 
cus. But  if  the  umbilicus  does  not  consolidate,  then  she  should  cover  it 
with  powdered  myrrh  or  aloe,  or  what  is  better,  powdered  myrtle. 

Then  having  tied  the  umbilicus,  the  midwife  should  lay  the  infant 
in  a  basin  or  mostellum  [pot?]  or  some  similar  vessel  filled  with  sweet 
water,  comfortably  warm,  not  stinging  nor  cold,  or  salty,  according  to 
the  custom  of  the  Greeks.  And  she  should  introduce  the  infant  into  this 
water  or  bath,  its  head  elevated  with  her  left  hand,  while  with  her  right 
hand  she  should  shape  its  head,  its  sightless  eyes,  cleanse  its  nostrils, 
open  its  mouth,  rub  its  jaws,  shape  its  arms  and  its  hands  and  every- 
thing. Next  she  should  wrap  it  up  in  a  linen  cloth  made  comfortably 
warm  and  rub  the  infant's  body. 

After  this,  she  should  cover  the  infant's  head  with  a  fine  linen  cloth 
after  the  manner  of  a  hood.  Then  secure  a  soft  linen  cloth  and  with  the 
infant  placed  on  the  midwife's  lap  in  such  a  way  that  its  head  is  toward 
her  feet  and  its  feet  rest  upon  her  body,  the  midwife  should  roll  it  in  the 
linen  cloth,  after  it  has  been  bathed,  wrapping  its  feet.  First  with  its 
arms  raised  above,  she  should  wrap  its  breast  and  bind  its  body  with  a 
band,  by  three  or  four  windings.  Next  the  midwife  takes  another  piece  of 
linen  or  little  cloth  and  draws  the  hands  of  the  infant  straight  forward 
towards  the  knees  and  hips,  shaping  them  evenly,  so  that  the  infant 
acquires  no  humpiness.  She  then,  with  the  same  assisting  band,  binds 
and  wraps  the  infant's  arms  and  hands,  all  of  which  will  be  correctly 
shaped. 


AD  ILLVSTRISSTMViM  PFUN 
CIPEM  DOMINVM  NICOLA 
VMTRVNODIGNISSIMVIVL 
DVCEM  VENETIARVM  DO 
MINVM  SVVMPRECIPVVM. 
LIBELLVS  DEEGRITVDrNl 
feVSINFANTIVM  PER  MAGI 
STRVM  PAVLVM  BAGELLAR 
DVM  A  FLVMINE  EDITVS  IN 
CIPIT  FOEL1CITER. 

Vantum  domui  tua*  illu' 

flriflfic  princeps  debea:  ncc 

Liuii  nec.Ciceronis  lingua 

aut  elocjuentia  exprimere : 

jaec  quiuis  alius  felici  fHlo 

comprehendere  poflet^  Na 

cu  puto  me  in  claru  uiru  olim  euafiflfe  dii' 

taxat  beneficiis  illius  preclarigenitoristui 

patririihonefKffimi:qui  meinnata  fibi  hu' 

manitacc  ad  mcdicinale  fedceuexitinqua 

oftofi^uigintifolarescirculoshonede  mili 

tauhlngratitudinis  nota  me  facile  fubittws 

facile  intelligcbam  ;  nifi  p  uiribus  eniterer 

all  quid  fake  in  taca  cue  felicicatisaplitudine 


First  page  of  Bagellardus. 


36  PEDIATRICS  OF  THE  PAST 

Then  she  should  turn  the  infant  over  on  its  breast  with  its  back  raised 
upward  and,  taking  hold  of  the  infant's  feet,  make  its  soles  touch  its 
buttocks  to  the  end  that  its  knees  might  be  properly  set.  Thereupon  she 
should  straighten  the  infant's  legs  and  with  another  band  and  little 
cloths  bind  and  wrap  up  the  hips.  Next  take  the  entire  infant  and  roll 
it  in  a  woolen  cloth  or  after  our  manner  in  a  cape  lined  with  sheep  skins; 
and  this  in  winter,  but  in  summer  in  a  linen  cloth  simply. 

Then  let  the  midwife  place  it  upon  a  bed  in  a  room  of  mild  tem- 
perature, not  too  light,  nay  rather  inclining  to  darkness,  lest  from  too 
much  light  the  infant  be  made  blind.  But  afterwards,  let  her  cover  it 
over  with  a  light  covering,  wrapping  a  piece  of  linen  around  its  head, 
not  touching  its  head,  lest  suffocation  in  time  follow,  and  so  allow  it  to 
sleep.  When  it  awakes,  moreover,  let  the  mother  or  attendant  women 
place  a  little  sugar  or  cooked  apple  with  a  mixture  of  sugar  in  the  infant's 
mouth,  for  this  is  a  most  excellent  and  praiseworthy  nourishment  and 
medicine,  since  it  incites  the  infant  to  expel  by  way  of  the  bowels. 

Let  the  infant  have  a  nurse  of  from  25  to  35  years  old,  who  is  of 
ruddy  complexion  or  not  far  from  it,  a  moderate  meat-eater  also,  not 
inclined  to  drunkenness,  but  of  good  morals  and  not  exercising  sexual 
intercourse.  If  the  infant  is  poor,  let  it  be  nourished  by  the  milk  of  its 
mother,  who  nevertheless  should  refrain  from  those  things  which  can 
disturb  or  impair  and  modify  the  milk,  such  as  all  sharp-tasting  things, 
leguminous  plants,  fat  meat  or  salt  meat,  salt  fish,  salty  cheese  and 
old  cheese  more  than  fresh,  anger  and  sexual  intercourse,  superfluous 
exercise,  bath,  and  drunkenness.  Such  a  nurse  should  feed  the  infant  by 
light  nursing,  lest  by  excessive  nursing  she  should  cause  coagulation  of 
the  milk  in  its  stomach.  When  the  nursing  has  been  finished,  let  her  put 
the  infant  in  the  cradle,  placing  over  it  a  covering  which  does  not  touch 
its  face,  push  the  cradle  to  and  fro  and  thereby  with  a  light  motion 
produce  a  gentle  slumber.  Let  her  chant  in  a  low  voice,  so  that  the 
infant's  spirits  rejoicing  in  harmony  may  become  cheerful.  Let  there 
be  no  noise  in  the  room  or  harsh  voice  or  anything  else  which  might 
frighten  the  infant. 

Let  the  midwife  bathe  it  with  an  ointment  two  or  three  times, 
according  to  the  present  custom,  although,  according  to  the  opinion 
of  the  ancients,  it  should  be  bathed  up  to  a  month.  But  because  up  to  a 
month  various  diseases  occur,  such  as  constipation,  crying  night  and 
day,  on  this  account,  while  the  constipation  lasts,  the  nurse,  taking 
the  excrements  of  a  mouse,  should  infuse  it  in  common  edible  oil  and 
insert  it  gently  in  the  infant's  anus,  and  if  it  suffer  pains,  rub  the  groin 
and  ribs  of  the  infant  with  oil  of  dill.  But  if  it  happen  that  the  infant 
suffer  epilepsy,  colic  and  analeptia,  let  the  applications  be  made  of 
which  we  are  about  to  speak  in  Part  11  which  follows. 


PAULUS  BAGELLARDUS  37 

Part  II 

CHAPTER  I.  ON  SAPHATI,  FAVOSITY  AND  ITS  CURE 

Although  the  diseases  which  befall  children  and  infants  are  various, 
according  to  their  complection,  nevertheless,  according  to  the  light 
which  the  Lord  will  impart,  we  shall  explain  their  diseases  up  to  the 
time  of  correct  enunciation,  which  is  7  years,  beginning  with  the  head 
as  the  seat  of  the  rational  soul  down  to  the  feet,  and  apart  from  what  we 
have  gathered  from  our  authorities  we  shall  relate  what  we  have  seen 
and  learned  from  experience  here  and  there. 

There  occurs,  therefore,  at  the  earliest  age  a  disposition  which  is 
called  saphati  or  favosity  or  in  our  tongue,  the  children's  plague.  This 
disease  is  caused  only  by  a  corruption  of  the  milk  or  its  superabundance 
or  by  a  disposition  contracted  from  the  mother's  womb  or  from  birth. 
And  although,  according  to  the  opinion  of  Rasis6  in  his  treatise  or 
pamphlet  "On  the  Diseases  of  Children,"  there  is  some  difference 
between  saphati  and  favosity,  because  in  saphati  there  is  no  scale,  but 
only  peeling,  while  in  favosity  there  are  pustules  from  which  emanates 
blood  mixed  with  corruption  or  water,  and  scales  appear  in  addition. 
And  yet,  according  to  his  opinion,  favosity  is  a  species  of  saphati,  and 
they  do  not  differ  except  in  degree;  and  from  the  fact  that  they  do  not 
occur  except  from  a  corruption  of  the  blood  or  of  the  milk  or  of  the 
blood  mixed  with  salt  phlegm,  as  it  is  called,  this  disposition,  according 
to  the  opinion  of  the  authorities,  is  in  no  way  to  be  cured  except  by  the 
cure  of  nature  or  with  her  guiding  the  infant  to  some  strange  disease. 
Indeed  such  saphati,  according  to  the  opinion  of  Galen,  Avicenna, 
Serapio,  Alliabas  and  nearly  all  authors  of  medicine,  relieves  the  infant 
or  preserves  it  from  various  different  diseases,  such  as  epilepsy,  the 
mistress  of  children  [mater  puerorum],  convulsion,  ringworms  and  nose- 
running,  and  from  melancholy  sufferings,  renders  the  infant  joyful  and 
happy. 

But  because  in  our  times  the  doctor  must  act  not  according  to  rules, 
but  at  times,  however,  not  totally  in  opposition  to  the  rules,  if  he  wishes 
to  learn  the  cure  of  this  disposition,  he  should  in  no  wise  check  it,  but 
rather  apply  the  medicaments  which  draw  lightly  and  gently,  washing 
the  head  gently,  with  the  face  turned  upward,  with  a  decoction  of 
pearl  barley  and  mallows.  Then  taking  coleworts  warmed  moderately 
over  ashes,  dress  them  with  a  butter  wash  and  apply  to  the  infant's 
head.  But  should  saphati  of  this  kind  be  checked,  then  he  should  take 
ivy  leaves  and,  sewing  them  together  after  the  manner  of  a  cap,  heat 
and  dress  as  described  above  concerning  the  coleworts. 

9  Rhazes.  The  name  has  been  left  as  in  the  original  both  in  this  book  and  in 
Roelans. 


38  PEDIATRICS  OF  THE  PAST 

But  since  the  disfigured  condition  of  the  face  is  sometimes  dis- 
tasteful to  the  mother  and  to  her  breasts,  then  the  mother  or  nurse,  to 
remove  herself  from  danger,  should  take  the  head  of  the  milk  and  smear 
the  face  of  the  infant,  continually  drawing  its  hand  towards  the  top 
of  the  head.  But  if  it  happens  that  the  infant  suffers  wakefulness,  and 
continually  moves  its  head  from  side  to  side,  because  of  the  fact  that  its 
hands  are  bound  by  the  band  and  therefore  it  cannot  scratch  with  its 
hand,  then  we  perceive  that  this  state  of  affairs  does  not  proceed  from 
anything  else  than  the  great  sharpness  or  poison  of  the  matter.  In  this 
case  let  the  nurse,  taking  atriplices,  heat  them  lightly  over  ashes  and 
apply  them  to  the  infant's  head,  for  it  draws  the  poison  or  sharpness 
of  the  humor  to  itself,  according  to  the  testimony  of  Rasis,  op.  cit., 
who  says  that  as  often  as  the  infant  cries  and  moves  continually,  we 
should  administer  leaves  of  atriplex.  I  too  have  learned  from  experience 
that,  should  the  infant  be  grown,  say  beyond  one  year,  then  the  follow- 
ing ointment  is  efficacious,  yet  after  the  nurse  has  been  purged  and 
herself  observes  the  proper  regimen : 

1^  cerussae,  Iithargyri  ana  3ss 

Iixivii  de  cineribus  vitis  3  iii 

olei  rosati  3i 

cerae  9    5  i 
Let  the  wax  be  melted  with  the  oil  of  rose,  and  the  other 

medicines  be  ground  and  all  prepared  with  2  yolks  of 
roasted  eggs. 

Another  for  the  same: 

1^  gallarum  3  iii 

granorum  almel  3" 

bauracon  aur.  unum 

sulphuris  citrini  aur.  ii 

arsenici  rubei,  aristolochiae  amborum  5ss 

salis  ammoniaci,  frusti  testudinis  veteris 
furni,  amygdalarum  amararum  excorti- 
catarum,  aeris  usti,  venarum  citrinarum, 
merdasengi,  radicum  caporum,  foliorum 
fici  siccorum,  radicum  arundinis  siccae, 
zimar,  aluminis  cameni,  siefmemitae,  olibam 
omnium  ana  aur.  i 

Let  the  medicines  be  ground  and  sifted,  and  prepared 
with  wine  vinegar,  until  reduced  to  an  ointment,  and 
placed  in  the  sun  until  thoroughly  mixed. 

Then  let  the  child's  head  be  smeared;  for  this  ointment  is  useful 
not  only  for  saphati  but  also  for  all  ulcers  of  the  head,  for  ringworms, 


PAULUS  BAGELLARDUS  39 

alopecia  (baldness),  and  for  nits,  lice,  and  for  scabies  and  also  for  similar 
ancient  diseases.  Among  the  remedies  tried  for  diseases  of  this  kind  is 
the  burned  or  dry  excrements  of  the  hen  mixed  with  honey.  Wonderful 
results  have  been  secured  from  adding  the  child's  urine  to  a  decoction 
of  the  roots  of  marshmallow  and  applying  it  to  the  head. 

CHAPTER  II.    ON  EPILEPSY 

Epilepsy  is  a  disease  which  restrains  the  animate  members  by  loss  of 
consciousness  and  checks  movements  almost  entirely  on  account  of  the 
obstruction  which  occurs  in  the  ventricles  of  the  cerebrum  and  in  the 
courses  of  the  sensory  and  motor  currents.  Now,  such  a  disease  is 
due  to  some  fear  or  noise  or  the  like.  Moreover,  it  happens  to  infants  in 
earliest  life  either  after  birth  or  at  birth. 

If  it  happen  from  birth,  it  is  not  to  be  cured,  or  scarcely  ever,  unless 
by  the  change  of  age  or  locality  or  seasons.  Hippocrates  testifies  to  this.7 
Avicenna  testifies  to  this8  as  do  nearly  all  the  authorities.  If  they  are 
not  cured  by  such  a  change,  they  die  with  it. 

If,  however,  it  comes  after  birth,  and  the  infant  be  nursing,  but  not 
consuming  food,  the  nurse  should  have  a  regimen  in  six  particulars 
which  are  not  natural,  namely,  have  air  free  from  all  bad  impression, 
beware  of  all  foods  multiplying  phlegmatic  matter,  such  as  are  some 
fishes,  milk  and  everything  made  with  pastry,  fat  meats,  dark  wine, 
legumines,  garlic,  scallions  (spring  onions)  and  all  greens  except  bugloss, 
sorrel,  borage.  Raw  fruits  should  also  be  avoided,  vinegar  and  all  hot 
things,  but  she  may  eat  meat  of  calves  or  kids  or  wether  sheep,  plovers, 
pheasants.  She  may  use  eggs  that  may  be  sucked  up. 

Let  their  milk  be  also  considered,  whether  it  be  watery  or  viscous — 
a  fact  which  is  ascertained  by  taking  a  drop  or  two  of  the  milk  and 
putting  it  or  milking  it  upon  the  finger  nail  or  clean  polished  iron  or 
marble  or  glass,  whereby  it  is  discovered  whether  the  milk  is  retained 
there  a  long  time  or  not.  If  by  turning  or  doubling  any  of  those  surfaces 
the  milk  is  retained  and  is  not  spilled,  we  understand  that  the  milk  is 
fat  and  viscous.  But  if  it  runs  off  without  turning  and  is  not  retained  in 
part,  then  we  learn  therefrom  that  the  milk  is  of  excessive  wateriness. 
[This  is  the  old  nail  test  of  Soranus  of  Ephesus.]  The  nurse's  milk  should 
be  rectified,  as  long  as  it  is  fat,  by  reducing  the  milk  itself  to  a  mean 
by  means  of  reducers  and  rectifiers.  All  of  this  will  be  discussed  a  little 
later  on. 

However,  because  such  a  disease  is  a  great  annoyance  to  the  infant, 
it  terrifies  both  the  father  and  mother  and  all  attendants.  And  since 
the  infant  can  take  nothing  by  way  of  the  mouth,  and  if  it  does  take 

7  Aphorisms,  part  u. 

8  De  epilepsia,  part  I,  chap.  iii. 


4o  PEDIATRICS  OF  THE  PAST 

anything,  it  is  not  much,  therefore  the  results  of  experience  in  the  cure 
of  epilepsy  are  set  forth. 

Now  the  judgment  of  many  authorities  is  that  an  emerald  sus- 
pended on  the  neck  removes  epilepsy.  The  judgment  of  all  authorities 
is  that  peony  suspended  in  some  way  or  other  on  the  neck,  either  the 
seed  or  the  root,  removes  epilepsy.  And  this  is  true  and  is  approved. 
In  like  manner  some  authorities  assert  that  if  one  were  to  burn  a  prickly 
pig  or  hedgehog  and  give  some  of  the  dust  to  drink,  it  suddenly  removes 
the  epilepsy.  Some  trustworthy  persons  testify  that  lignum  crucis,  a 
lignum  which  arises  upon  the  oak  and  hence  becomes  viscous,  when 
suspended  on  the  neck  removes  epilepsy  and  all  vertigo.  But  among 
the  remedies  especially  tried  is  theriaca  magna  or  andromachi,  mixed 
with  woman's  milk,  with  a  little  sugar  of  roses.  Yet  the  elders  should 
keep  infants  away  from  all  terror  and  noise,  which  tend  to  bring  on 
such  a  disease. 

CHAPTER  III.    ON  CONVULSIONS  OF  CHILDREN 

Convulsions  happen  to  children  from  repletion  or  inanition;  from 
repletion  especially  in  the  fleshy,  from  inanition  in  infants  either  because 
of  fevers  which  give  rise  to  convulsions  or  because  of  prolonged  crying, 
whence  it  happens  sometimes  that  infants  stiffen  so  that  they  cannot 
be  bent  either  upward  or  downward,  which  condition  according  to  some 
is  called  alcuhes  or  alcuses.  If,  therefore,  they  suffer  convulsions  from 
repletion,  the  nurse  should  be  watched,  lest  her  milk  decline  to  excessive 
humidity,  i.e.,  lest  the  milk  be  watery,  but  she  should  be  nourished  more 
on  foods  which  tend  to  fatten  the  milk,  and  the  infant  must  abstain 
from  excessive  nursing  and  excessive  sleep,  likewise  its  members  should  be 
smeared  with  the  oil  of  iris,  i.e.,  of  white  lilies,  or  with  the  oil  of  alkirum. 

If,  however,  it  happens  that  the  infant  is  dried  up,  the  nurse  should 
be  fed  with  foods  which  are  moist  in  substance  as  well  as  quality,  such 
as  are  praiseworthy  meats  boiled  with  cold  and  moist  things,  and 
especially  if  such  a  convulsion  exist  after  continued  fevers.  Moreover, 
the  joints  should  be  smeared  with  violet  oil  and  a  little  wax. 

Some,  however,  put  the  infant  into  a  bath.  From  boiling  down  the 
heads  of  young  porkers  or  wether  sheep  or  young  goats  until  their 
melting,  they  make  a  decoction  of  these  meats,  and  put  the  infant 
in  such  a  bath.  Then  they  make  an  ointment  of  the  above-mentioned 
oils.  Yet  I  know  from  experience  that  I  have  seen  many  infants  so 
stiff  that  they  could  not  be  bent  upward  or  downward,  who,  by  the 
mere  application  on  the  spondyles  of  the  neck  of  oil  of  white  lilies  or 
wet  hyssop,  are  relieved  and  cured  by  the  favor  of  the  Lord  from  such 
a  contraction.  But  among  the  remedies  especially  tried,  particularly 
when  a  humid  convulsion  persists,  is  theriaca  magna  or  andromachi. 


PAULUS  BAGELLARDUS  41 

CHAPTER  IV.    ON  PERSISTENCE  OF  WAKEFULNESS 

Children  also  may  have  spells  of  wakefulness  which  produce  sleep- 
lessness and  cries  disturbing  to  the  nurses  and  all  within  the  house. 
There  are  various  names  applied  by  authorities  to  this  occurrence,  but 
the  curing  must  always  be  begun  with  the  lighter  remedies,  since  all 
things  which  provoke  sleep  are  narcotic  and  in  a  certain  measure  stupefy- 
ing. Beginning  with  the  lighter  remedies,  therefore,  let  there  be  made 
an  anointing  of  the  forehead  and  nostrils  with  violet  oil.  Secondly,  with 
violet  oil  and  oil  of  dill  mixed  with  the  milk  of  the  women  nursing  it, 
and  a  modicum  of  wax.  Thirdly,  add  to  the  above-mentioned  ointment 
a  little  opium  or  juice  of  hyoscyamus  or  mandragora.  Fourthly,  I  would 
make  an  anointing  with  poplar  ointment,  yet  with  light  movement  and 
in  a  small  quantity.  And  although,  according  to  the  opinion  of  our 
authorities,  we  ought  rather  to  proceed  through  external  applications, 
yet  sometimes  it  happens  that  something  is  administered  internally, 
so  that  the  infant  consumes  food,  takes  a  little  bread-broth  with  emul- 
sion of  white  poppy  seed,  although  Rasis  also  would  administer  black 
poppy,  which  I  do  not  approve,  or  its  emulsion.  Moreover,  our  people 
administer  to  infants  a  little  of  that  medicament  which  is  called  requies 
in  the  description  of  Nicolaus.  Although  this  be  recommended  by  him, 
nevertheless  it  should  not  be  used  except  in  urgent  necessity. 

CHAPTER  V.    ON  DISEASES  ON  THE  EYES  IN  INFANTS 

Infants  are  subject  to  various  and  diverse  diseases  of  the  eyes, 
namely,  ophthalmia,  swelling  of  the  eyes,  strabismus.  The  first  two 
diseases  of  the  eyes  especially  occur  from  cold  or  corruption  of  the 
milk.  But  strabismus  is  contracted  either  from  the  beginning  of  birth 
or  on  account  of  bad  regulation  of  the  position  of  the  infant  in  regard 
to  light  or  method  of  lying. 

If  therefore  swelling  of  the  eyes  occur  and  there  be  redness  in  the  face 
and  red  color  in  the  forehead,  then  the  following  medicine  is  beneficial: 
1$  succi  menthae,  foliorum  rosarum  ana  5  i 

croci,  myrrhae  ana  5iss 

Let  them  be  pulverized  and  prepared  with  woman's 
milk  and  placed  under  the  eyes  outside  and  on  the  fore- 
head, renewing  daily  until  the  eyes  are  opened. 

But  if  there  has  been  no  redness  in  the  eyes,  nor  heat  in  the  face  and  on 

the  forehead: 

1$  myrrham,  crocum,  aloem  et  folia  rosarum  and  prepare 
with  good  wine,  especially  tested  for  this  purpose;  put 
into  nostrils  of  the  infants  a  little  amber  distempered 
with  woman's  milk. 


42  PEDIATRICS  OF  THE  PAST 

If,  however,  infants  have  the  itch  or  scabies  with  the  mere  draining 
of  the  nurse's  milk,  the  greatest  attention  is  required. 

If  the  infants  suffer  strabismus  or  crossing  of  the  eyes,  they  should 
especially  be  placed  on  opposite  sides.  For  example,  if  the  eyes  are  ele- 
vated and  twisted  toward  the  left  angle  or  lacrimal,  the  infants  should 
be  placed  so  that  they  lie  on  the  right  side  and  the  light  should  be 
placed  at  the  right  side,  so  that  from  gazing  at  that  light  their 
eyes  might  be  given  direction.  But  on  the  other  hand,  if  the  eyes  be 
twisted  towards  the  right  lacrimal  or  towards  the  right  side,  then  the 
child  and  his  light  must  be  placed  in  the  opposite  manner. 

If,  however,  the  eyes  are  crossed  conversely,  one  to  the  right  and 
the  other  to  the  left,  then  the  infant  must  be  placed  on  the  flat  of  his 
back  and  allowed  to  look  at  a  chalybeate  mirror  of  spherical  shape  or 
very  pretty  pictures  or  something  pleasing,  so  that  from  proper  gazing 
and  pleasure  it  may  behold  the  figures  or  images  represented,  by  which 
procedure  the  eyes  are  given  direction  by  the  correctness  of  vision. 
And  in  this  way  because  of  continued  observation  the  eyes  are  strength- 
ened in  their  natural  arrangement  or  position. 

CHAPTER  VI.    ON  INTERNAL  DISEASES  OF  THE  EARS 

Sometimes  children  have  a  few  pustules  inside  the  ears,  emitting 
corruption  and  water,  in  which  there  is  a  severe  itch,  whereby  children 
are  annoyed  and  the  nurse  likewise  on  account  of  the  cries  from  pain. 
And,  although  much  is  said  by  the  authorities,  yet  a  few  tried  remedies 
we  shall  set  forth.  The  first  is,  take  old  cotton,  i.e.,  lately  carded,  and 
place  in  the  ears  after  the  manner  of  a  tent;  cleanse  the  corruption 
coming  from  the  ulcer,  and  again  insert  another  clean  tent.  The  second 
is,  insert  a  tent  saturated  with  common  oil  or  water  of  honey;  and  if 
the  infant  happens  to  be  relieved,  let  the  tent  be  repeated  until  complete 
cure.  But  if  the  corruption  still  runs  out,  then  let  the  above-mentioned 
tent  saturated  with  water  of  honey  and  powder  of  iris  or  of  myrrh  or 
of  aloe  be  introduced  until  complete  cure.  Another  remedy  is  similarly 
efficacious  for  the  same  affection:  take  alum  and  dissolve  in  wine  and 
dip  in  Iycion  and  introduce  it.  Take  also  nitre  and  grind  it  with  water 
and  vinegar  and  introduce  it.  But  if  the  infant  be  not  relieved  by  these, 
then  you  may  know  that  the  fistula  was  produced  internally  and  the 
infant  will  not  be  relieved  except  by  change  of  age. 

CHAPTER  VII.    ON  EXTERNAL  ABSCESSES  OF   THE  EARS 

Sometimes  children  have  behind  the  ears  pustules  of  different  colors, 
namely,  white,  yellow,  black  and  red.  Now  the  black  ones  are  in  cer- 
tain measure  fatal,  although  remedies  ought  to  be  applied  to  them;  the 


PAULUS  BAGELLARDUS  43 

yellow  ones  are  of  minor  evil  effects,  while  the  white  ones  are  health- 
ful as  well  as  the  red  ones,  which  in  no  wise 'can  be  cured  when  the  infant 
takes  nothing  by  way  of  the  mouth.  But  rather  should  the  nurse  be  sub- 
jected to  a  regimen.  Rasis  testifies  to  this,  in  his  treatise, "On  Diseases  of 
Infants."  Isaac,  "On  Ailments  of  Children,"  testifies  to  the  same  effect; 
likewise  the  most  distinguished  Avicenna,  "On  the  Regimen  of  Infants."9 

The  remedies  for  them  should  be  applied  externally,  and  as  long  as 
the  yellow  pustules  remain,  we  may  cure  in  this  way.  Let  the  nurse  be 
nourished  on  cool  vegetables,  such  as  endive,  scariola  [a  kind  of  endive], 
lettuce  and  cucumber,  according  to  Avicenna. 

But  if  the  pustules  are  of  white  color,  then  let  her  be  nourished  on 
fennel,  wild  majoram,  i.e.,  a  decoction  of  these  herbs,  with  the  flesh  of  a 
wether  sheep  or  of  a  calf  or  of  chickens. 

If,  however,  the  pustules  be  black,  although  fatal,  as  the  authorities 
testify,  the  regimen  is  more  to  be  used  in  youths  than  in  infants.  The 
nurse  must  be  nourished  on  foods  made  with  a  decoction  of  bugloss,  hops 
and  the  above-mentioned  flesh  meats;  and  doctored  with  medicines 
which  correct  the  bad  quality,  the  burning  blood.  There  are  also  syrups 
of  thyme,  of  fumaria,  of  citric  acid,  with  appropriate  waters,  say  water  of 
bugloss,  of  hops  and  of  maidenhair.  Then  there  must  be  an  evacuation 
by  appropriate  means,  such  as  is  an  electuary  of  thyme,  of  senna,  in  solu- 
tion or  not,  fumaria  and  Indian  pills.  And  although  according  to  the 
opinion  of  Rasis,  in  the  above-mentioned  treatise,  there  are  correspond- 
ing great  antidotes,  yet  they  are  abhorrent  in  our  times,  therefore,  I 
shall  pass  them  by. 

But  if  it  happen  that  these  pustules  make  a  large  protuberance,  just 
as  large  abscesses  sometimes  happen  to  arise  behind  the  ears  or  inside  the 
ears,  then  let  an  application  be  made  with  oil  of  lilies  or  with  oils  of 
chamomile  and  the  fat  of  a  hen,  of  a  fresh  duck  or  a  little  butter  and  with 
the  ointment  which  is  called  anodyne,  i.e.,  soothing.  But  if  the  abscess 
be  not  dissipated  by  these,  take  a  plaster  made  of  a  decoction  of  marsh- 
mallow  roots  with  fresh  hog's  lard  and  let  it  mature;  then  let  it  be  opened 
with  a  lancet  or  breaker;  finally,  let  the  surgeon  busy  himself  in  making  it 
firm  and  clean. 

CHAPTER  VIII.    ON  PUSTULES  OR  ALCOLA  OF  THE   MOUTH 

There  also  happen  to  children  pustules  inside  the  mouth,  and  alcola 
on  the  tongue  and  on  the  palate  of  different  color,  because  some  are  ashen, 
some  white,  some  red,  some  yellow  and  some  black.  Some  of  these  are 
healthful,  in  fact  all  except  the  black  which  in  a  certain  measure  partake 
of  the  nature  of  a  cancer.  Therefore  we  pass  by  the  cure  of  the  black  ones, 
because  this  belongs  more  to  the  surgeon  than  to  the  physician. 

9  Bk.  1,  part  in. 


44  PEDIATRICS  OF  THE  PAST 

But  if  they  are  yellow  or  red  and  the  heat  ascertained  by  placing  the 
finger  inside,  then  the  nurse  should  be  nourished  and  fed  on  cool  vege- 
tables, such  as  endive,  purslane,  scariola,  chicory,  lettuce  and  the  like, 
so  that  her  milk  may  be  the  cause  of  extinguishing  the  heat  and  the 
sharpness  of  the  choler  and  of  the  blood. 

If,  however,  the  pustules  are  white,  she  should  be  nourished  rather  on 
those  which  have  power  to  alter  the  blood  and  the  milk,  such  as  is  done 
by  a  decoction  of  calaminthe,  borage,  fennel  and  similar  things  which 
have  power  to  remove  the  malice  of  the  blood. 

The  child's  palate,  when  the  pustules  are  yellow  or  red,  must  be 
anointed  with  water  of  a  decoction  of  wild  pomegranate  flowers,  pome- 
granate barks,  husks  of  acorns,  or  with  juice  of  purslane  or  of  plantain, 
scariola,  evergreen,  or  juice  of  nightshade.  But  of  the  remedies  especially 
tried,  as  Rasis,  Avicenna  and  Isaac  testify  in  their  proper  places,  is 
diamoron  [a  medicament  composed  of  juice  of  black  mulberries 
and  honey]  or  juice  of  the  mulberry  and  rob  nucum  [the  juice  of  ripe 
fruit  mixed  with  honey].  I  too  have  tried  this  not  only  in  alcola  or 
pustules,  but  in  corrosion  of  the  gums  and  tongue  of  infants. 

CHAPTER  IX.    ON  PAIN  OF  THE  GUMS  OF  INFANTS 

At  the  time  of  dentition,  children  are  subject  to  intense  pains  of  the 
gums,  and  the  more  intense  the  pains,  the  more  firm  will  be  the  teeth. 
If,  moreover,  the  time  of  dentition  be  the  spring,  the  teeth  will 
come  through  rapidly  on  account  of  the  supervening  warmth  of  the 
atmosphere.  If,  however,  it  be  summer,  they  come  through  more  slowly, 
on  account  of  the  coolness  of  the  autumn  following;  if  winter,  still  more 
slowly,  on  account  of  the  coolness  of  the  season.  But  if  it  happen  in 
autumn,  it  will  be  worse,  on  account  of  its  dryness  and  coolness. 

Moreover,  the  bulgings  appearing  in  the  gums  must  be  assisted  by 
rubbing  them  with  the  hands,  because  then  the  infants  emit  slobberings 
and  humors.  And  when  they  nurse,  they  strike  the  papillae  of  the 
breasts,  and  when  the  finger  is  interposed,  they  strike  with  a  vigorous 
blow.  Therefore  they  must  be  aided;  so  take  a  virginal  wax  candle, 
freshly  made,  and  give  it  to  the  infant  to  chew  on,  because,  by  reason  of 
its  softness  and  the  oiliness  of  the  wax,  some  dilation  of  the  gums  is 
caused.  Also  make  an  ointment  of  flaxseed  oil  or  of  the  mucilage  of 
flax,  or  of  the  seed  of  mallows,  or,  as  long  as  excessive  heat  of  the  gums 
persists,  of  the  mucilage  of  quince-seed. 

As  appropriate  remedies,  moreover,  are  recommended  duck  fat  and 
fresh  buttef  which  is  not  salty.  But  with  the  last  praise  is  recom- 
mended the  cerebrum  of  a  hare  and  the  milk  of  a  nursing  dog.  The  last 
remedy,  however,  is  to  scratch  the  gums  with  a  light  scratching.  Some 
authorities,  moreover,  prescribe  that,  during  the  entire  time  in  which 


PAULUS  BAGELLARDUS  45 

the  pain  of  the  gums  endures,  a  decoction  of  chamomile  be  made  with 
which  the  teeth-heads  are  washed,  and  if  the  pain  is  increased,  take  cow's 
butter  or  the  medulla  of  its  leg  and  place  it  on  the  gums.  When  the 
teeth-heads  appear,  let  clean  wool  be  placed  on  the  head  and  neck  of 
the  child  and  thus  allow  it  to  be,  since  this  is  a  customary  and  approved 
cure. 

CHAPTER  X.    ON  FISSURES  OF  THE  LIPS 

Children  are  also  subject  to  fissures  of  the  lips,  which  are  caused  in 
them  either  on  account  of  the  sharpness  of  the  milk  or  the  hardness  of 
the  breasts  or  corruption  of  the  milk.  If  it  be  from  the  sharpness  of  the 
milk,  then  the  nurse  must  be  regulated  by  the  aforenamed  vegetables. 
If  from  corruption  of  the  milk,  the  milk  must  be  rectified,  as  was  said 
before.  But  if  from  the  hardness  of  the  breasts,  the  nipples  of 
the  women's  breasts  must  be  softened.  Let  the  lips  of  the  infant  there- 
fore be  smeared  with  rosewater  mixed  with  oil  or  chicken  fat;  and  taking 
well-carded  wool  and  putting  it  with  the  juice  of  the  plantain  or  of  the 
ribwort  with  butter  or  chicken  grease,  make  an  ointment  for  the  lips. 
But  among  the  remedies  most  tried  is,  take  rosewater  and  corn  starch 
and  make  an  ointment. 

Among  the  remedies  tried  not  only  for  fissures  of  the  lips,  but  also  of 
the  nipples,  hands  and  feet  of  the  virgin,  the  old  woman  and  the  mother: 

]fy  Cerae   citrinae,    adipis   anatis, 

hyssopi  humidae,  olei  rosati  ana  partem  unam 

tragaganthi,  anuli,  mucilaginis 

cydoniorum  ana  partem  >£ 

gallarum,  cineris  pilorum  cau- 

dae  equi,  sulphuris,  plumbi  usti  ana  partem  unam  et  M 

Let  the  things  to  be  ground  be 

ground  and  mixed. 

Let  an  unguent  be  made  for  the 

lips. 

Let  the  following  powder  be  sprayed  on : 

1$  Mastiches,  gallarum,  cineris  cau- 
dae  equi,  plumbi  usti,  corticum 
granatorum,  cerussae,  tragaganthi, 
corticum  thuris  ana  partes  aequales 

Let  all  be  moistened  in  Pontic  Wine 
for  a  day  and  a  night;  dry  them  in 
the  sun  and  let  the  powder  be 
extra-sifted. 


46  PEDIATRICS  OF  THE  PAST 

For  the  same: 

1^  Lithargyri,  myrrhae,  tragaganthi  ana 

Let  them  be  pulverized  fine  and  let  an  ointment  be 
made  with  wax,  oil  and  honey. 

But  first  let  the  lips  of  the  infant  be  moistened  with  its  own  saliva. 
Next  with  pieces  anointed  and  saturated  with  this  ointment,  apply  to 
the  lips  at  night;  in  the  morning  wash  the  lips  with  lukewarm  water. 

For  the  same  ointment: 

1^  Cerussae  3i 

cerae  5  iii 

lithargyri,  cachiniae,  argenti,  masticis  ana  3M 
olei  rosarum  quantum  sufficit 

Let  an  ointment  be  made. 

Another  for  the  same: 

1^  Cyperi,  aluminis,  gallae,  myrrhae,  arsenici,  plumbi 
usti  singulorum  ana 

cum  modico  oleo  rosaceo 
Let  an  ointment  be  made. 

It  is  especially  potent,  as  often  as  there  is  present  a  blackness  in  the 
fissures  of  the  lips. 

CHAPTER  XI.    ON  ABSCESSES  OF  THE  THROAT 

Children  are  also  subject  to  abscesses  around  parts  of  the  throat, 
such  as  are  abscesses  of  the  tonsils  and  are  called  commonly  gaiones. 
These  abscesses  are  caused  either  on  account  of  the  coolness  of  the  air 
repressing  the  substance  of  the  cerebrum  or  on  account  of  excessive  heat 
or  on  account  of  excessive  fulness  of  the  infant  from  superfluous  nursing. 

Now  their  cure  is  to  be  sought  with  diligence,  because  they  don't 
know  how  to  talk.  Let  the  nurse  or  some  one  else  discover  whether  it  is 
suffering  fever  or  not  and  whether  it  is  suffering  difficulty  of  deglutition ; 
and  when  it  begins  to  sleep,  whether  it  seems  as  if  to  be  suffocated. 
Then  she  should  put  her  finger  inside  the  throat  and  by  light  touch  learn 
from  the  sides  of  the  throat,  where  she  may  discover  its  presence,  whether 
there  is  not  an  abscess.  If  she  find  any  by  means  of  her  finger,  she  should 
raise  the  abscess  from  the  lower  extremity  of  the  throat,  raising  it  up 
lightly,  first  on  one  side,  then  on  the  other,  and  thereafter  smear  it  with 
diamoron  or  rob  nucum  or  with  myrtle  syrup. 

Externally,  however,  an  application  must  be  made  of  oil  of  lilies  with 
chicken  or  duck  fat,  applying  externally  sappy  wool  or  linen  or  carded 


PAULUS  BAGELLARDUS  47 

flax;  or  taking  the  linen  or  flax  and  pouring  on  it  the  child's  urine,  apply 
it  externally  to  the  throat. 

Among  the  other  remedies  most  tried  is  a  cassia  stem  lately  extracted 
from  the  reed  and  ground  as  finely  as  possible;  apply  it  to  the  throat  in 
the  form  of  a  plaster.  But  according  to  the  opinion  of  Mesue,  "On  the 
Cure  of  Quinsy,"  the  ears  should  be  drawn  upward  or  the  hairs  which 
are  on  the  top  of  the  head  should  be  so  drawn.  But  this  pertains  rather 
to  those  who  know  how  to  speak  than  to  infants. 


CHAPTER  XII.  ON  COUGH  AND  CATARRH 

Infants  are  subject  to  a  cough  together  with  catarrh  either  from  a 
cold  on  the  tongue  so  that  they  can  scarcely  close  the  epiglottis, 
sometimes  from  a  cold  on  the  chest,  while  sometimes  on  account  of 
matter  descending  from  the  head. 

We  understand  that  the  cough  comes  from  a  cold  on  the  tongue, 
when  they  can  scarcely  swallow  and  do  not  emit  slobberings.  Then  they 
are  to  be  cured  with  an  administration  of  sweet  almonds  pounded  up, 
which  are  mixed  with  fat  figs  and  water  of  fennel.  Let  it  be  administered 
in  the  morning  and  in  the  evening,  if  they  can  swallow.  But  if  not,  merely 
making  an  ointment,  with  the  finger  or  a  feather  apply  on  the  throat 
itself  milk  of  sweet  almonds  or  juice  of  licorice  with  corn  starch  and  milk 
of  almonds. 

But  if  a  cough  be  present  and  roughness  of  the  throat,  then  with  a 
mucilage  of  quince-seed  and  penide  [barley  sugar  or  the  like]  with  oil  of 
sweet  almonds;  and  this  when  fever  is  not  present.  But  if  fever  be  present, 
take  the  juice  of  a  sweet  pomegranate,  mix  with  penide  and  juice  of 
licorice. 

If  the  cough  come  from  catarrh,  which  we  discover  when  infants 
emit  slobberings  with  a  quantity  of  phlegm  around  the  mouth,  then 
these  medicines  are  appropriate: 

IJ  seminis  papaveri  albi,  tragaganthi  ana  3  % 

cucumeris  5  i 

Prepare  with   water  in   which  sebesten  have 
been  boiled  and  administer. 

Likewise  another  for  the  cough: 

1$  passulas  enucleatas 

Bring  to  a  boil  in  an  iron  vessel,  lest  they  harden;  after- 
wards remove  from  the  fire,  pound,  and  mix  with'  penide 
of  the  same  quantity.  Give  to  the  child  in  the  morning 
and  in  the  evening  to  the  middle  of  the  night. 


48  PEDIATRICS  OF  THE  PAST 

For  the  same  on  account  of  a  cold  cough: 

Q  myrrham 

Mix  with  honey  and  oil  of  almonds  and  give  to  drink, 
where  no  fulness  of  the  chest  exists. 

If  fulness  be  present,  take  tragaganthum,  galbanum  and  mix  with  the 
yolk  of  an  egg. 

Although  many  remedies  for  this  have  been  recommended  by  the 
authorities,  as  are  those  which  have  already  been  mentioned,  among 
the  remedies  especially  appropriate  in  our  times  are  the  following:  If 
an  infant  be  of  little  age,  namely  two  or  three  months,  even  up  to  three 
years,  and  the  cough  is  caused  by  means  of  diarrhea,  make  an  appli- 
cation of  an  ointment  on  the  chest  beginning  with  lighter  remedies. 
Taking  butter  which  is  not  salty  and  cabbages  torrefied  over  ashes,  smear 
the  cabbages  with  the  said  butter.  Then  apply  one  leaf  of  cabbage  to  the 
chest,  another  to  the  back  correspondingly  opposite  to  the  chest,  or  make 
an  application  of  oil  of  sesame  or  of  sweet  almonds  with  chicken  fat  and 
fresh  butter,  adding  violet  oil  and  a  little  crocus  with  wax.  Apply  also 
some  of  the  ointment  which  is  called  byssop  bumida,  or  make  an  oint- 
ment from  the  mucilage  of  the  seed  of  mallows  or  of  flax.  If  fever  be 
present,  let  it  be  anointed  with  violet  oil  and  almond  oil  with  a  little  wax. 

If  the  cough  be  from  catarrh  and  clings,  then  sprinkle  a  little  powder 
of  roses  and  sandarach  on  the  juncture  of  the  head.  It  is  also  of  help  to 
give  a  pill  of  storax;  but  if  the  infant  cannot  take  it,  even  if  it  be  like  a 
grain  of  millet  or  of  the  bitter-vetch  or  of  the  lentil,  then  this  medicine 
is  useful,  namely  frequently  at  the  time  of  nursing. 

1$  gummi  arabici,  seminis  cydoniorum,  glycyrrhizae,  peni- 
diarum 
Let  them  be  mixed  with  milk;  administer  to  the  infant. 

If,  however,  the  children  happen  to  be  grown,  three  or  seven  years,  and 
suffer  a  cough  from  catarrh  as  well  as  stricture  of  the  breast,  then  syrup  of 
licorice  is  useful,  as  long  as  there  is  no  fever,  with  syrup  of  horehound  and 
water  of  farfara,  of  maidenhair;  but  as  long  as  there  is  fever,  with  violet 
syrup.  And  let  applications  of  ointments  be  made  to  the  breast.  Prescribed 
pills  are  useful,  as  are  those  of  hiera,  of  larch  fungus,  up  to  the  number 
of  five. 

Sometimes  the  cough  happens  to  come  from  a  stricture  of  the  nostrils, 
because  of  humor  which  ought  naturally  be  emitted  through  the  nostrils 
is  transmitted  to  the  throat  and  the  trachean  artery.  Then  an  ointment 
made  of  butter  alone  and  applied  at  the  base  of  the  upper  part  of  the 
nose  between  the  two  eyes  is  useful.  Also  place  in  the  nostrils,  with  a 
feather  or  cotton,  oil  of  sweet  almonds  or  sesame,  and,  if  the  children 


PAULUS  BAGELLARDUS  49 

can  draw  through  the  nostrils,  a  decoction  of  barley  with  white  sugar  or 
barley  water,  with  a  modicum  of  water  of  marjoram  or  juice  of  spinach. 

Beneficial  results  will  also  come  from  a  medicine  which  diverts  the 
matter  from  the  lower  to  the  upper  parts,  and  from  gentle  and  light 
blows  of  the  spatula.  The  latter  is  not  done  unless  purging  has  preceded 
either  through  the  os  or  by  means  of  a  common  syringe  or  honey 
suppository. 

CHAPTER  XIII.    ON  VOMITING 

Now  infants  are  troubled  by  vomiting  either  because  of  an  excess  of 
milk,  which  they  cannot  digest,  or  on  account  of  the  wateriness  or  corrup- 
tion of  the  milk,  together  with  an  excessive  weakness  in  the  stomach,  or 
on  account  of  worms  or  coolness  of  the  air  or  coolness  and  warmth  of 
the  nurse.  Consequently,  the  greatest  care  must  be  employed  in  discover- 
ing the  causes  of  vomiting  in  an  infant,  since  we  can  by  no  means  acquire 
this  knowledge  from  its  mere  description.  Therefore  you  should  inquire 
of  the  mother  or  nurse  whether  the  infant  consumes  a  great  quantity  of 
milk  and,  when  sucking  the  breasts,  runs  into  sobbing,  or  whether  the 
milk  is  said  to  be  very  watery  or  grossly  viscous.  This  knowledge  we 
acquire  through  the  signs  laid  down  above,  concerning  the  regulation  of 
the  nurse's  milk. 

Now  we  discover  its  corruption  from  the  foulness  of  the  vomit  which 
emits  a  sharp  odor  instead  of  the  odor  of  milk. 

We  discover  the  frigidity  either  of  the  nurse  or  infant  from  vomits 
which  are  emitted  on  linen  cloths.  If  they  are  green  or  livid,  we  consider 
this  to  be  caused  by  the  coolness  of  the  nurse  or  infant.  But  if  the  color  of 
the  vomit  is  yellow  or  black  with  translucence,  we  consider  this  to  be 
caused  by  the  warmth  of  the  milk  or  inflammation  of  the  infant. 

If,  however,  the  vomit  itself  has  arisen  from  an  excess  of  milk,  then 
you  should  stop  it.  If  the  sharp  odor  be  detected,  let  three  grains  of  barley 
be  mixed  with  milk  in  a  white  liquid,  according  to  Avicenna  who  speaks 
doubtfully;  administer  to  the  infant,  and  it  will  thereby  be  cured.  But 
according  to  the  common  method  of  practitioners,  an  applicaton  is  made 
on  the  infants'  stomach,  where  it  is  weak,  with  oil  of  spike  and  of  quince- 
seed.  This  is  approved  not  only  for  infants,  but  also  for  children  of  seven 
years  and  beyond. 

Against  the  vomiting  due  to  worms,  do  as  follows : 

]$  olei  de  absinthio,  de  mentha,  masticini 

et  cydoniorum  _  ana  3" 

specierum  absinthii,  menthae,  rosarum  ana  &H 
aloes  grana  duo 

aceti  parum 


50  PEDIATRICS  OF  THE  PAST 

cerae  quantum  sufficit 

Let  a  soft  ointment  be  made. 

Indeed  infants  who  suffer  a  lapse  of  appetite,  when  an  application 
has  been  made  before  nursing  in  the  morning  and  in  the  evening,  suck 
the  milk  with  appetite.  If  the  infants  can  swallow,  according  to  the 
opinion  of  Avicenna,  "On  the  Cure  of  Vomiting"10  and  "On  the  Cure  of 
Choleric  Affection,"11  administer  a  little  mint  syrup  with  wine  of  pome- 
granates. It  is  wonderfully  beneficial  to  infants  and  grown  children. 
Note  this  restriction,  however,  that  in  no  wise  is  vomiting  to  be  restrained 
unless  it  endures  to  the  point  of  weakness  or  fatigue,  because  very  fre- 
quently vomiting  cures  vomiting,  as  Avicenna  testifies.12 

These  remedies  are  also  beneficial,  according  to  Rasis,  where  the  cause 
is  cold: 

1$  oliban  septimam  partem  drach. 

rutae  siccae  tertiam  partem 

Pulverize  it  and  mix  with  rose 
syrup  and  give  to  the  child. 

Let  the  nurse  take  a  little  cumin,  a  little  sumach  and  put  it  into  the 
child's  mouth;  or  take  what  has  been  often  tried,  according  to  the  opinion 
of  Rasis : 

1$  Iigni  aloes,  masticis  ana  3  V£ 

galangae  septimam  partem  drach. 

Let  a  powder  be  made,  which 
is  prepared  with  rose  syrup. 

Give  to  the  child  before  it  takes  its  milk,  then  place  on  its  stomach  this 
plaster: 

1$  masticis,  aloes,  acaciae,  gallae,  oliban,  panis  usti        ana 
Prepare  with  rose  oil  and  apply  to  the  stomach. 

It  is  tried  for  vomiting  and  saliva  of  children. 

If,  however,  there  was  a  sharp  odor  in  the  vomiting,  and  the  things 
which  are  vomited  forth  appear  sharp  and  yellow,  then  administer  to 
the  infant  rob  agrestae  or  juice  or  sap  of  quince  seed  or  syrup  of  barberry 
or  currant  syrup  or  rose  wine.  If  the  infants  be  grown,  the  following 
troches  will  be  beneficial: 

1$  rosarum,  spodii  ana  5  i"i 

gallarum  3  iiss 

10  Bk.  in,  ch.  xiii. 

11  Bk.  in,  ch.  xvi. 

12  On  the  Cure  of  Choleric  Affection,  bk.  in,  ch.  xvi. 


PAULUS  BAGELLARDUS  51 

Karabe,13  seminis  portulaccae,  seminis  Iapathi 
acuti  ana  3i 

Prepare  with  water  of  roses  or  of  pomegran- 
ate to  the  weight  of  1  dram,  then  let  one 
troche  be  pulverized  and  with  sugar  of  roses 
or  sap  of  quince  seed  or  of  currant  syrup. 
Give  to  the  infant  either  a  part  or  the  whole. 

Finally  let  there  be  applied  to  the  stomach  a  plaster  which  helps  the 
vomiting  and  the  flow  of  the  bowels : 

1$  farinae   ordei,   rubi  viridis,   mali 

granati  corticis  ana  quantum  sufficit 

Mix  with  rose  water  or  olive  oil  of 
roses  and  apply  to  the  stomach. 

But  according  to  the  opinion  of  Isaac,  where  there  is  phlegmatic 
vomiting,  take  calaminthe,  crocus,  long  serpentaria  and  mix  with  mint 
juice;  administer  to  the  infant.  The  results  are  wonderful.  The  nurse 
must  be  restrained  from  fat  and  pituitous  foods,  from  sexual  intercourse, 
and  if  she  be  pregnant,  she  must  be  changed  altogether. 

CHAPTER  XIV.    ON  DIARRHEA 

Now  infants  are  troubled  by  flow  of  the  bowels,  not  only  at  the  time 
of  dentition,  but  after  and  before,  from  various  causes,  either  on  account 
of  corruption  of  the  milk  or  superabundance,  or  warmth,  coolness, 
wateriness,  or  on  account  of  excessive  deglutition  of  saliva  or  on  account 
of  the  milk  of  a  pregnant  nurse  or  from  weakness  of  the  stomach.  If  it 
happen  from  corruption  of  the  milk,  the  milk  should  be  rectified  by  those 
means  which  shall  be  mentioned  below  concerning  the  rectification  of 
milk.  If  it  be  from  superabundance,  the  infant  must  abstain  from  exces- 
sive nursing.  If  from  the  warmth  of  the  milk,  which  is  discovered  from  the 
yellow  color  of  the  stools,  or  if  from  coolness  and  humidity  of  the  nurse 
or  milk,  the  milk  should  be  rectified  as  shall  be  stated.  If  on  account  of 
weakness  of  the  stomach,  poultices  are  useful  and  the  ointments  named 
above  on  the  cure  of  vomiting  from  warmth  or  coolness. 

But  first  one  thing  must  be  noted,  that  never  is  the  flow  of  the  bowels 
to  be  checked  unless  there  be  present  a  tumor  producing  weakness.  For 
this  flow,  beginning  with  the  lighter  remedies,  according  to  Avicenna, 
we  should  poultice  the  stomach  with  a  decoction  of  seed  of  roses,  cumin 
and  anise — and  this  when  the  flow  happens  from  coolness — or  from 
cumin  or  roses  infused  and  boiled  down  in  vinegar.  But  if  this  does  not 
help,  take  a  sixth  part  of  a  dram  of  goat's  milk  and  with  cool  water  give 
to  the  infant. 

18  Karabe  =  amber. 


52  PEDIATRICS  OF  THE  PAST 

Among  the  remedies  tried  whenever  the  cool  cause  exists,  take  one 
scruple  of  torrefied  rhubarb  and  administer  it  with  aromatic  wine. 
Rasis  also  teaches  us  to  administer  a  fourth  part  of  a  dram  of  oliban  with 
the  following  plaster  which  is  applied  on  the  bowels  and  stomach : 

1^  croci,  myrrhae,  cerae  quod  sufficit 

Mix  with  wine,  for  the  bowels. 

If,  however,  the  flow  happen  from  a  warm  cause,  let  the  infant  take, 
if  it  can,  syrup  of  roses  or  sap  of  quince-seed  with  syrup  of  mint  and  make 
the  sap  or  sugar  of  roses  predominate.  Among  the  remedies  also  tried 
are  torrefied  nut  centers  and  let  the  infant  take  it  before  dinner  and  sup- 
per; with  sorb  also  and  cotonea  roasted  or  pounded  and  applied  to  the 
bowels,  if  the  infant  cannot  swallow.  The  following  plaster  is  also  of 
service : 

1^  dattillos  immaturos 

Let  them  be  moistened  during  a  night  in  a  styptic  wine, 
then  take  flaxseed  oil  or  oil  of  myrtle  or  mastic,  for  the 
oils  are  varied  according  to  what  you  wish  to  make  warm 
or  cold.     Let  the  plaster  be  applied  to  the  bowels. 

Beneficial  to  the  flow  from  a  warm  cause  is  the  following: 

1$  succi  arnoglossae,  centinodiae  ana5H 

farinae  tritici  5  iii 

aceti  parum 

albuminis  ovorum  duorum 
Distemper  and  warm  and  apply  to  the  bowels. 

But  if  you  wish  to  check  a  little  more  vigorously : 

1}  rosarum,    thuris,    masticis,    boli    armeni,     sanguinis 
draconis,  absinthii,  costi  amari,  balaustiae,  psidii 
Let  them  be  boiled  in  water  and  in  this  decoction  let  the 
child  sit.  Also  put  a  warm  application  on  the  feet  and  the 
tibiae. 

If  you  wish  to  check  still  more  vigorously,  take  two  parts  of 
Symphytum  and  two  parts  of  plantain  and  of  Ianceola  and  with  their 
juices  dissolve  argil.  Work  it  with  the  hands  into  the  form  of  a  plaster 
and  apply  upon  the  umbilicus. 

Familiar  remedies  which  are  in  common  use  are  enemas  with  a 
decoction  of  barley  torrefied  with  honey  of  rose,  as  long  as  there  is  no 
scraping  of  the  intestines.  If  the  latter  be  present,  take  some  goat's  or 
sheep's  suet  and  troches  of  amber  or  of  terra  sigillata  or  of  dandelion  or 
of  powder  of  roses  or  use  powder  of  burnt  thapsia  barbata.  Apply  to  the 
bowels  a  plaster  of  diaphoenicon  according  to  the  description  of  Mesue  as 


PUALUS  BAGELLARDUS  53 

a  result  of  either  the  discovery  of  Andromachi  or  his  own;  also  an  oint- 
ment of  barks  or  a  plaster  of  roses  on  the  authority  of  Mesue,  or  of 
gallia  according  to  the  description  of  the  same  writer. 

But  if  you  desire  to  know  other  remedies  which  might  check  the 
bowels,  read  the  private  papers  of  Galen  and  you  will  find  a  plaster  bene- 
ficial to  spittle  of  blood,  vomiting  and  flow  of  the  bowels.  The  same  may 
be  had  from  Rasis  in  his  own  private  papers. 

CHAPTER  XV.    ON  CONSTIPATION 

Sometimes  infants  are  troubled  by  a  checking  and  constipation  of 
the  feces  either  from  the  viscosity  of  the  milk  or  because  they  consume 
too  binding  foods,  such  as  are  cheese  or  quinces  or  chestnuts  or  roasted 
nuts  or  sorb  and  medlar  and  others  such.  If  the  infant  be  nursing  and 
suffers  constriction  of  the  bowels  from  the  viscosity  of  the  milk — a 
condition  which  is  recognized  in  the  nurse  or  the  mother  by  the  means 
mentioned  above  and  according  to  the  opinion  of  Avicenna,  "On  the 
ailments  of  infants"1* — a  potion  of  mouse  excrements  must  be  given  or  a 
suppository  of  honey  cooked  either  with  horse-mint  or  iris  roots,  which 
are  green  or  burned.  We  ought  also  to  administer  to  the  infant  a  little 
honey  or  turpentine  about  the  size  of  a  chick-pea  and  its  stomach 
ought  to  be  rubbed  with  common  oil  or  on  its  thigh  should  be  placed 
cow's  gall. 

Yet,  according  to  the  common  manner,  it  is  a  tried  remedy  used  during 
the  first  months  to  make  suppositories  of  mouse  excrements  crushed  with 
honey  and  salt  or  of  hog's  lard  and  mouse  excrements  with  common 
salt  or  of  salt  bacon  smeared  with  oil,  a  remedy  which  is  commonly 
used,  or  use  a  soft  injection  made  of  chicken  broth  or  sheep's  head 
broth  with  sugar  and  a  little  salt,  but  without  oil  lest  the  infant  suffer, 
if  it  have  worms  which  would  seek  the  upper  parts  on  account  of  the  oil. 

Good  results  also  come  from  an  injection  made  of  the  milk  of  goats  or 
of  asses,  or  of  camels,  which  is  better,  but  because  parents  are  greatly 
troubled  and  are  unwilling  to  obey  the  doctors  in  the  giving  of  a  supposi- 
tory or  an  enema,  then  you  should  take  a  half  shell  of  a  large  edible  nut 
and  fill  it  with  fresh  butter,  with  bull's  gall,  and  apply  it  upon  the  umbil- 
icus and  smear  the  infant's  entire  belly  or  his  feet  with  butter,  yet  with 
light  movement. 

]$  hellebori   albi   et   nigri,    hermodactylorum, 

acori,  succi  sempervivae,  bryoniae  ana  partes 

aequales 
cum  axungia  porcina  veteri 
Prepare  and  use. 

14  A  chapter  in  bk.  i,  part  in. 


54  PEDIATRICS  OF  THE  PAST 

And  although  ointment  of  arthanite  is  appropriate,  nevertheless  it  is 
dangerous  and  should  therefore  rather  be  abandoned.  Appropriate  also 
are  suppositories  of  heads  of  leeks  with  salt. 

But  the  usual  remedy  we  shall  not  pass  by,  namely,  take  penide  and 
mould  a  suppository,  then  infuse  it  in  salt  water  and  place  under  the 
infant.  But  if  the  infant  cannot  receive  it  either  below  or  above,  then  the 
nurse  or  the  mother  must  use  medicine  and  after  the  lapse  of  five  hours 
the  infant  should  nurse.  If,  however,  it  can  swallow  anything,  namely  is 
two  or  seven  years  old,  the  usual  soothing  medicines  should  be  adminis- 
tered, such  as  is  hiera  simplex  or  picra  [i.e.,  powder  of  aloes  and  canella] 
compound  up  to  one  dram  together  with  woman's  milk  or  aromatic 
wine.  But  because  hierae  are  detestable  on  account  of  their  bitterness, 
give  cassia  extracta  or  manna  in  aromatic  wine  or  a  little  of  the  infusion 
of  rhubarb  or  Indian  electuary  or  of  psyllium  or  diaturbit  with  rhubarb, 
according  to  necessity  and  the  diversity  of  subjects  at  fault,  or  pills  of 
aloes  or  of  hiera  simplex — all  this  should  be  according  to  the  judgment  of 
the  operator,  because  we  cannot  operate  except  in  accordance  with  the 
difference  of  condition. 

But  there  is  one  tried  remedy  in  potable  form  which  we  shall  not  omit: 

1^  cinnamomi,  zingiberis  ana  partem  unam 

spicae,  anisi  ana  partem  J^ 

epithymi  partes  octo 

rhei,  sennae  ana  partes  quattuor 

sacchari  optimi  partem  mediam 

Let  all  be  administered  with 
woman's  milk  or  aromatic  wine  or 
some  fat  broth,  up  to  half  a  dram. 

This  confection  is  also  appropriate: 

1^  folliculorum  sennae  viridium  mun- 

datorum  ana  5  i 

cinnamomi  5iii 

croci  3i 

sacchari  ad  pondus  omnium 

Dose   is   half  a  dram  with  broth. 

But  if  they  be  grown,  i  dram — and 

this  before  meals. 

CHAPTER  XVI.    ON  TENESMUS  AND  CONTINUED  INCLINATION  TO 

STOOL 

Infants  are  subject  to  a  very  troublesome  disease,  which  inspires 
fear  in  their  parents  when  they  see  the  infant  continually  stimulated  to 
emit  something  on  the  stool  and  yet  emitting  nothing.  This  is  called 


PAULUS  BAGELLARDUS  55 

malum  de  ponti  in  the  vulgar  tongue,  but  by  doctors  is  termed  tenesmus. 
And  some  is  true  and  some  false.  False  tenesmus  comes  from  fecal 
matter  ensnared  and  adhering  to  the  right  intestine,  in  the  inner  part 
near  the  phiter  or  anus,  while  true  tenesmus  is  caused  on  account  of  a 
salt  or  choleric  humor  descending  to  the  anus  itself  either  because  of 
the  coolness  of  the  air  or  because  the  infants  sit  upon  a  hard  surface, 
such  as  living  stone. 

Therefore  the  cure  of  such  a  disease,  if  the  tenesmus  is  caused  by  the 
ensnarement  of  the  feces,  is  to  bring  forth  the  feces  with  mollifying 
injections.  And  this  is  the  cure  of  tenesmus  which  is  false,  because  in 
tenesmus  three  intentions  must  be  had.  The  first  is  towards  a  griping 
which  is  followed  by  a  vehement  inclination  to  stool  without  however 
any  emission.  The  second  intention  is  a  restriction  of  the  blood  being 
evacuated  and  the  cleansing  of  the  ulceration.  The  third  is  the  restoration 
of  the  intestine  inside  when  it  emerges. 

Regarding  the  first  intention,  Aliabas  said  that  if  oliban  be  given 
with  ameum,  it  removes  the  inclination  to  stool.  Serapio,  however,  claims 
that  the  bark  of  the  tree  pinus  minor  made  into  a  plaster  removes  the 
tenesmus  caused  by  sharp  material  flowing  to  the  right  intestine  or  even 
by  an  ulcer,  provided  nevertheless  the  intestine  first  be  cleansed.  We  too 
have  found  by  experience  that  the  bark  of  pinus  maior  made  into  a 
plaster  and  pulverized,  sprinkled  with  Iicivium  or  introduced  with  egg 
albumen  or  oil  of  myrtle  produces  the  same  result. 

Serapio  said  that  psyllium  destroys  the  roughness  of  the  ulcers  of  the 
intestines  and  removes  the  tenesmus.  He  also  said  that  without  a  decoc- 
tion of  the  bitter  vetch  or  with  a  decoction  of  vinegar,  of  pectin,  and 
applied  above  is  beneficial,  yet  it  is  more  beneficial  with  a  decoction  of 
unfruitful  pine-cones.  But  I  know  from  experience  that  a  suffumigation 
made  from  pine-cones  from  which  the  centers  have  been  extracted 
soothes  tenesmus  wonderfully.  Isaac  said  that  an  injection  made  of  a 
decoction  of  flax-seed  with  oil  of  rose  is  good  for  tenesmus  and1  ""the 
griping  of  the  intestines;  similarly  even  a  decoction  of  flaxseed. 

The  second  [original  has  tertia,  evidently  a  mistake]  intention  will  be 
more  for  the  checking  of  the  blood.  And  although  much  is  said  by  the 
authorities,  yet  here  I  shall  adduce  some  tried  remedies.  Wine  in  which 
pomegranate  root  has  been  boiled,  when  quaffed  affords  much  relief. 
Beneficial  also  is  fine  powder  of  pollicaria  applied  as  long  as  the  tenesmus 
from  a  cool  cause  exists.  Likewise  a  fumigation  made  of  grains  of  myrtle. 
Serapio  said  that  gum  arabic  checks  loose  bowels  and  unites  firmly  the 
intestine. 

Concerning  the  third  intention,  which  is  the  introduction  of  the  intes- 
tine which  has  emerged,  brown  hairs  on  top  of  the  intestine  withdraw  it 
inside,  but  as  a  remedy  in  the  cure  of  a  bad  case  of  tenesmus  when  a  fever 
exists,  take  Galen's  pills  from  his  private  papers: 


56 


PEDIATRICS  OF  THE  PAST 


1%  opii,  anisi  amborum 
seminis  hyoscyami  albi 
seminis  apii  5 

Let  them  be  ground  and  prepared 
with  wine  and  thence  let  pills  be 
made  after  the  fashion  of  a  pep- 
per. Administer  two  at  the  most. 

Lycium  is  a  remedy  for  the  same. 
1$  myrrhae,  thuris,  croci,  opii 


ana  aur.  unum  et  ^2 
5  iii 
viii 


ana  partem  unam 


Let  them  be  ground,  sifted  and  pre- 
pared with  egg  yolks  and  let  small 
acorns  be  made,  tied  with  a  thread 
and  introduced  through  the  anus, 
until  the  infant  sleeps,  and  then  with- 
drawn. 

But  in  the  cure  more  familiar  are  washing  injections  of  a  decoction 
of  torrefied  barley  and  plantain  roots.  For  example, 

1^  radicum  plantaginis  M.  unum 

ordei  torrefacti  cum  cortice  suo  M.  duos 

Let  them  be  boiled  completely  in  four  pounds 
of  water  and  let  it  be  filtered.  Add  to  the  fil- 
trate one  ounce  of  filtered  honey  of  rose. 
Let  an  injection  be  made. 

It  is  beneficial  also,  if  it  be  made  of  the  juice  or  decoction  of  plaintain 
or  arnagloss,  in  which  juice  should  be  dissolved  troches  of  amber  or  terra 
sigillata. 

For  the  same  ailment  the  following  poultice  is  beneficial.  Let  cabbages 
be  boiled  in  water  and  squeezed  lightly  with  the  hands  and  cooled  a 
little  in  oil  of  roses.  Then  let  the  infant  sit  upon  the  cabbages.  Suffu ne- 
gations are  efficacious  made  of  colophony,  pine-cones  or  their  barks. 

Lastly,  let  the  following  bath  be  made. 

1^  radicum  cardui,  quo  praeparantur  panni  M.  quattuor 
corticum    granatorum,    balaustiae,    cor- 
ticum 

radicum  auri,  thapsi  barbati  ana  M.  unum 

Let  them  be  boiled  in  water,  if  there  be 
fever,  but  if  there  is  not,  in  dark  styptic 
wine  of  sufficient  quantity  for  the  bath, 
in  which  the  patient  should  sit  up  to  his 
navel. 


PAULUS  BAGELLARDUS  57 

It  has  been  learned  from  experience  that  drinking  the  juice  of  the 
common  sorrel,  i.e.,  rumex  sylvestris,  on  an  empty  stomach,  either  of 
uncooked  food  or  otherwise,  draws  back  the  anus  which  has  emerged.  I 
know,  too,  from  experience  that  in  the  case  of  a  certain  infant,  the  son  of 
a  public  treasury  official,  who  was  suffering  a  lapse  of  the  anus  about  two 
fingers  distance  and  cured  by  a  mere  decoction  of  roses,  shelled  lentils 
with  dark  wine  followed  by  a  greasing  with  oil  of  roses  and  a  suffumiga- 
tion  of  incense  and  barks  of  pine-cones  and  roses,  also  he  was  cured  at  the 
same  time  of  a  large  tumor  and  abscess  of  the  intestine.  Wonderful 
results  come  from  suppositories  made  of  goat's  grease  with  oil  of  rose  and 
a  little  opium,  about  a  grain  or  two. 

CHAPTER  XVII.    ON  WORMS  OR  LUBRICA  IN  INFANTS 

Infants  are  made  very  restless  by  worms  whether  they  be  slippery  or 
cup-shaped  or  round,  for  all  of  these  are  generated  from  phlegmatic 
matter,  yet  different  according  to  their  diversity  and  in  different  parts  of 
the  intestines.  But  they  are  not  generated  from  the  bile,  because  it  is 
especially  opposed  to  such  rottenness;  nor  from  the  blood,  on  account  of 
the  great  predilection  which  virtue  has  towards  it — which  we  learn  from 
the  fact  that  worms,  of  whatsoever  kind  they  may  be,  are  neither  yellow 
nor  black  nor  red — but  only  from  phlegm  putrified  in  the  intestines.  The 
cause  of  their  generation  is  said  to  be  superfluous  eating,  together  with 
weakness  of  digestion,  and  this  refers  to  all  fruits  and  Iegumines,  espe- 
cially kidney-beans  and  beans,  as  well  as  the  consumption  of  milk  when 
already  full  and  briefly  the  regimen  of  food  in  six  matters  which  are  not 
natural,  multiplying  the  corruption  of  the  humors  in  the  stomach  by 
way  of  indigestion. 

In  nursing  infants,  however,  they  are  generated  because  of  corruption 
of  the  nurse's  milk  or  taking  of  food,  just  as  in  our  times  women  masti- 
cate food  and  bits  of  food  and  administer  the  food  thus  masticated  to  the 
infants.  Special  care  must  be  taken  against  this  when  the  women  are 
menstruating  or  have  exercised  or  have  been  warmed  up  from  anger  or 
immediately  after  eating  or  after  having  had  sexual  intercourse,  for  then 
their  saliva  is  poison  to  the  infants  for  these  very  reasons.  But  if  they 
wish  to  nourish  the  infants  on  that  chewed  food,  let  them  be  free  from 
every  vice  which  could  corrupt  the  food  or  saliva. 

Therefore  let  the  infants  be  cured  and  freed  from  worms  according  to 
the  different  authorities.  Some  begin  with  external  applications;  others, 
however,  rather  with  those  remedies  which  may  be  administered  by  way 
of  mouth.  But  for  the  present,  following  the  opinion  of  Rasis,  about 
springtime  begin  with  the  remedies  which  are  applied  externally.  There 
are  said  to  be  two  especially  tried  remedies.  [One  is]  the  juice  of  garlic. 
Garlic,  according  to  the  opinion  of  Avicenna,  is  the  last  in  killing  worms, 


58  PEDIATRICS  OF  THE  PAST 

where  he  mentions  safflower,  mint,  germander,  centaury,  pennyroyal 
and  garlic  properly  so  called.  The  other,  however,  is  especially  used  in 
practice. 

1$  porrorum  non  transplantatorum  Mii 

Let  them  be  moistened  lightly  and  placed  upon 
a  warmed  tile  and  sprinkled  with  white  vinegar, 
then 

1$  diptami,  gentianae,  seminis  sancti  ana  9ii 

Let  the  leeks  be  placed  with  the  said  species  in 
two  little  bags.  Let  one  be  placed  upon  the  os 
stomachi  and  the  other  upon  the  thirteenth  rib 
opposite  to  the  stomach. 

But  lower  down,  good  results  come  from  injections  made  rather  of 
chicken  broth  with  sugar,  or  purging  cassia,  not  using  oil,  but  rather  in 
place  of  the  oil  applying  butter  and  a  little  salt  and  milk  of  goats,15  of 
camels  or  cows,  etc.,  as  you  will  see.  Take  a  little  galban,  put  it  in  the 
yolk  of  an  egg.  Although  in  this  matter  many  things  are  recommended  by 
the  authorities,  just  as  what  has  been  mentioned,  and  although  benefit  is 
derived  sometimes  from  injections  which  draw,  according  to  the  opinion 
of  the  authorities,  they  are  not  appropriate  unless  signs  of  great  corrup- 
tion are  apparent  and  the  bodies  are  grown.  Suppositories  are  recom- 
mended, made  with  honey,  salt  and  penide  either  of  hog's  lard  or  bacon, 
and  the  results  are  wonderful.  If  the  worms  continue  in  the  right  intes- 
tine, let  the  said  suppository  be  made  immediately;  on  account  of  the 
oiliness  of  the  lard  and  fat,  they  cling  to  the  suppository  and  emerge 
through  the  anus  with  the  suppository.  Briefly,  everything  bitter  kills  off 
the  worms. 

CHAPTER  XVIII.    ON  SWELLING  OF  THE  BELLY  IN  INFANTS 

Infants  are  subject  to  tumor  or  inflation  of  the  belly  so  that,  by 
touching  or  striking,  it  sounds  like  the  noise  of  cymbals.  This  is  called 
tumor  according  to  the  opinion  of  some  authorities,  according  to  others 
ventus  inflatiliSy  and  according  to  others  ventus  inflantis.  But  suffice  it  to 
say  that  tumor  of  the  belly  from  wind,  as  a  condition,  is  contracted  either 
from  birth  or  from  a  neglect  by  the  midwife  who  bathes  it  or  neglect  of 
the  nurse  or  because  it  was  not  kept  from  the  cool  air. 

If  the  tumor  or  condition  was  contracted  from  birth,  it  can  in  no  wise 
be  corrected.  If  from  neglect  of  the  nurse  who  bathes  it,  let  what  we  are 
15  Here  seems  to  be  an  interpolation  of  directions  to  the  printer  as  follows:  "Since 
that  which  now  follows  here  should  not  be,  but  what  should  follow  after  this  phrase 
'cum,'  let  it  be  continued  through  the  beginning  of  the  other  page,  which  begins 
'saccaro.'  " 


PAULUS  BAGELLARDUS  59 

about  to  say  be  done.  If  from  the  nurse,  the  regimen  which  we  shall 
mention,  or  which  was  mentioned  above  concerning  the  regimen  of  the 
nurse,  is  in  order.  If,  therefore,  the  infant  be  of  tender  age,  namely  six 
months  up  to  two  years,  and  suffers  by  the  neglect  of  the  midwife  or  cool 
air,  beneficial  results  come  from  the  application  to  the  hypochondria, 
the  stomach  and  the  umbilicus  of  an  ointment  made  of  oil  of  dill.  The 
following  medicament  is  also  beneficial,  although,  it  should  not  be  applied 
except  upon  urgent  necessity,  on  the  authority  of  Avicenna,  "De  regi- 
mine  infantium.,,16 

1$  origani,  castorei,  cymini  ana  partes  aequales 

Let  them  be  triturated  vigorously 
and  mixed  and  given  to  the  infant 
in  a  potion,  by  weight  of  three 
grains  of  barley,  with  milk  or  aro- 
matic wine. 

Another  remedy,  according  to  the  opinion  of  Rasis,  is : 
1$  myrrham,  aloem  et  crocum 

Prepare  with  juice  of  satureia  and  apply  to  the  belly. 

But  of  the  remedies  tried  in  these  times,  take  a  diaphoenicum  plaster, 
according  to  the  description  of  Mesue,  and  a  plaster  of  melilot,  accord- 
ing to  the  description  of  the  same  authority,  and  apply  to  the  belly.  I 
have  seen  this  work  wonders  in  a  certain  Hebrew  boy  of  three  years,  who 
was  suffering  this  disease  and  was  cured.  I  have  also  seen  in  the  case  of  a 
country  boy,  a  poor  little  fellow  of  two  years,  whose  father,  although 
unable  to  purchase  medicine,  bade  him  take  cow's  excrements,  as  soon 
as  passed  by  the  cow,  and  smear  his  body,  and  he  was  cured  miraculously 
by  the  aid  of  God. 

CHAPTER  XIX.    ON  DIFFICULTY  OF  URINATING  IN  INFANTS 

Infants  are  especially  troubled  when  they  cannot  pass  urine,  and 
twist  and  turn  and  cry  out,  while  the  parents  are  saddened  and  the 
doctors  are  aroused  because  they  do  not  know  the  causes  of  the  infant's 
pain.  This  condition  especially  must  be  relieved,  because  it  is  caused  only 
by  cold  or  condition  of  the  milk  or  from  a  stone.  If  from  cold,  it  is  relieved 
by  oil  of  dill  or  of  chamomile  alone,  or  oil  of  white  lilies  or  of  scorpions, 
which  latter  should  be  applied  only  when  the  other  remedies  do  not  serve 
the  purpose.  Beneficial  also  are  poultices  made  from  a  decoction  of  wall 
pellitory,  flowers  of  chamomile,  melilot  and  dill  on  the  breast  of  the 
infant,  or  a  bath  of  a  decoction  of  the  ingredients  just  mentioned.  But 
among  the  most  beneficial  remedies  is : 

16  bk.  i,  part  in. 


6o  PEDIATRICS  OF  THE  PAST 

T$  maxillas  Iuciorum  salitorum 

Let  a  fine  powder  be  made  of  them  and  administer  with 
aromatic  wine. 

Efficacious  also  for  the  same  ailment  is  the  root  of  filipendula  boiled  in 
wine;  administer  a  little  of  that  wine.  Of  service  too  is  cucurbita  antiqua, 
in  which  the  oil  has  been  retained;  let  it  be  warmed  in  warm  water  with- 
out letting  the  water  enter  it,  and  when  it  has  been  warmed,  let 
the  infants  pubes  be  placed  over  the  mouth,  for  it  provokes  urine  and 
removes  the  pain  of  the  urinating  organ.  Moreover,  it  is  known  from 
experience  that  taking  Iapathus  acutus  (sorrel)  and  putting  into  a  fire, 
even  though  she  be  a  little  girl,  so  that  it  will  glow  before  her,  and  even 
though  she  be  a  grown  woman,  she  will  immediately  pass  water. 

But  if  the  difficulty  of  urination  is  caused  through  the  fault  of  a  stone, 
it  must  be  determined  whether  the  stone  be  in  the  kidneys  or  in  the  blad- 
der. And  the  method  is,  take  morsus  gallinae,  which  is  an  herb,  and  let  it 
be  boiled.  Let  this  be  placed  in  the  form  of  a  plaster  upon  boy's  or  girl's 
pubes,  and  if  the  pain  is  increased,  it  is  a  sign  of  stone  in  the  bladder;  but 
if  not,  of  the  kidneys.  Now  among  the  appropriate  remedies  is  the  admin- 
istration of  powder  of  peony,  and  especially  to  infants.  Serapio  says  that 
cumin  removes  the  pain  and  the  stone  in  the  bladder.  Dioscorides  asserts 
that  if  a  bit  of  cardomon  be  taken  with  the  water  of  a  decoction  of  barks 
or  of  roots  of  laurel,  it  breaks  the  stone  and  diminishes  it  in  the  bladder. 
Alchatabrius  says  that  the  water  of  a  decoction  of  polytrichum. 

Experiments  are  many,  as  well  for  stone  in  bladder  as  in  the  kidneys, 
but  we  shall  adduce  just  a  few.  The  first  is,  let  the  blood  of  a  single  hare 
be  removed  so  many  times  and,  with  seven  ounces  of  sassafras  roots,  be 
burned  in  a  rough  earthenware  pot.  Let  a  spoonful  of  these  ashes  be 
given  and  wine  with  a  cup  of  warm  water.  A  plaster  placed  upon  the 
pubes  breaks  the  stone  in  the  bladder  and  placed  upon  the  kidneys 
breaks  the  stone  in  the  kidneys. 

1}  amygdalas  amaras  et  dulces  ana  partes  aequales 

Let  them  be  pounded  and  with 
resin  of  pine,  turpentine  and  oil  of 
scorpions  made  according  to  the  art 
and  let  a  plaster  be  made. 

If  you  lack  oil  of  scorpions,  use  oil  of  bitter  almonds  or  of  nards.  An 
electuary  for  the  same : 

1$  liptum  tripon  et  instini  nycolai  ana  5  i  ss. 

Iapidis  iudaici  3i  ss. 

Let  them  be  combined  and  with  fine  warm 
wine  administered,  as  much  of  this  as  a  chest- 
nut, the  plasters  being  left  in  their  places. 


PAULUS  BAGELLARDUS  61 

Efficacious  for  the  same  is  oil  of  scorpions,  made  according  to  the  art 
and  administered  alone.  The  experiment  of  Rasis: 

1$  nuces  virides  numero  vi 

and  pound  with  their  outside  shells,  then 
1$  porrorum  non  Iotorum  9i 

From  both  extract  the  strained  juice,  which 
rests  in  a  glass  jar  until  purified  and  give  to 
the  boy  every  morning  for  seven  days  and  at 
the  time  of  sleep,  smear  the  penis  and  the 
testicles  with  old  oil  or  oil  of  ben. 

Beneficial  also,  according  to  the  opinion  of  Avicenna  and  Serapio,  are 
many  simple  things  separately  or  mixed  with  others,  such  as  maidenhair, 
sea  sponge,  almonds,  cubebs,  senecio,  kidney  stone  and  serpent  stone. 
And  the  beneficial  compounds  are  dialacca  maior  and  minor,  diasulphur 
(according  to  Mesue),  oil  of  cherries,  oil  of  seeds  of  henna,  oil  of  scorpions. 
According  to  Nicolaus  the  following  are  beneficial:  aurea  Alexandrina, 
antidotum  emagogum,  sweet  electuary,  philanthropos,  .Iitumtripon, 
mithridate,  theriaca  magna,  oppopira  magna  and  the  like. 


CHAPTER  XX.    ON  INCONTINENCE  OF  URINE  AND  BED-WETTING 

Parents  are  especially  saddened  as  a  result  of  bed-wetting,  when 
either  boys  or  infants  beyond  the  age  of  three  years  continually  pass 
water  in  the  bed,  and  this  sometimes  not  only  within  the  space  of  a  single 
day  or  two  days,  but  continually,  every  night,  and  not  only  up  to  the  age 
of  five  or  six  years,  but  sometimes  beyond  the  time  of  puberty  [Latin 
original  is  ubertatis,  evidently  for  pubertatis].  This  is  said  to  be  very  base 
and  in  a  certain  measure  unfortunate  for  the  boys  thus  born.  And 
although  there  may  be  many  causes  for  their  passing  water,  while  they 
themselves  are  not  conscious  of  it,  because  of  the  brevity  of  this  work  we 
shall  bring  forward  only  those  remedies  which  have  been  recommended 
by  the  authorities  and  are  true,  yet  always  preceded  by  a  purging  of  the 
body,  if  they  be  infants  who  can  be  purged  of  humidities,  a  prob- 
able cause  of  the  relaxation  of  the  vesical  muscles. 

We  shall  begin  the  cure,  therefore,  by  premissing  the  due  adminis- 
tration of  six  matters  not  natural.  Let  them  beware,  then,  of  coldness  of 
temperature  and  all  food  and  drink  tending  to  aggravate  the  stomach 
and  corrupt  digestion;  let  them  sleep  in  a  convenient  slumber;  let  them 
make  use  of  moderated  exercise;  let  them  avoid  the  accidents  of  mind, 
such  as  crying,  immoderate  exercise  from  anger.  Now  of  the  things 
recommended  by  the  authorities,  Avicenna  says  that  medlar  and  sorb 
are  beneficial  for  excess  of  urine.  Fidelis  asserts  that  galanga  checks 


62  PEDIATRICS  OF  THE  PAST 

urine  and  its  flow  caused  by  cold  of  the  kidneys  and  bladder.  A  scud  [a 
wisp  of  twisted  straw,  used  for  stopping  a  drain]  also,  according  to  every 
method  of  its  administration,  is  beneficial  for  inability  to  check  urine, 
when  humidity  or  cold  or  both  are  causes.  Likewise,  too,  the  use  of  enula 
aids  excess  flow  of  urine  due  to  cold  and  humidity.  Serapio  says,  and 
Alcafabrius  too,  that  scoria  of  iron  mixed  with  wine  or  infused  therein  or 
diluted  many  times  therein,  when  imbibed  dries  up  the  humidity  which 
relaxes  the  muscle  and  strengthens  it. 

Dioscorides  said  that  the  cerebrum  of  a  hare,  ground  and  imbibed, 
corrects  bed-wetters.  And  Fidelis  said  that  the  lung  of  a  kid  when  eaten 
and  made  into  a  plaster  restrains  incontinence  of  urine.  He  also  said  that 
the  bladder  of  a  young  breeding  sow,  when  pulverized  and  imbibed, 
checks  urine.  Rasis  said  that  if  you  remove  the  comb  of  a  cock  and  dry 
it  and  triturate  it  and  scatter  on  the  bed  of  the  bed-wetter  without  his 
knowledge,  he  is  cured.  It  is  known  from  experience  that  if  the  urine 
passed  is  thick  and  rough,  if  a  syrup  be  made  of  a  decoction  of  the  flowers 
of  nenuphar  and  is  quaffed,  immediately  that  urine  is  checked  and 
clarified. 

I  myself  know  from  experience  that  the  flesh  of  a  ground  hedge-hog 
checks  the  flow  of  urine,  so  that  if  it  be  frequently  administered,  it  pre- 
vents the  passing  of  urine,  although  in  this  matter  there  seems  to  be  con- 
troversy, because  Avicenna  asserts  that  the  flesh  of  a  hedge-hog  softens 
the  bowels  and  provokes  urine;  so,  too,  Rasis.  Yet  if  one  considers  their 
dicta,  he  will  understand  that  what  is  said  is  true;  the  experiment  is 
true  and  has  been  proved  by  me. 

1^  maxillae  Iucii,  non  salitae,  pulverisatae  subtiliter 
Administered  in  the  morning  and  evening  they  removed 
nocturnal  wetting. 

A  second  experiment  is  that  the  inside  skin  of  the  stomach  of  hens 
which  in  our  idiom  is  called  requesta  and  is  the  one  wherein  women  or 
cooks,  when  they  cleave  the  stomach  of  hens  in  twain,  raise  up  a  certain 
little  skin  in  which  food  is  contained  or  digested  and  is  cast  forth  from  it. 
Now  such  a  skin  dried  and  pulverized,  imbibed  morning  and  evening, 
removes  nocturnal  wetting  marvelously,  not  only  for  boys,  but  for  adults 
of  either  sex,  and  aids  the  stomach  wonderfully.17 

CHAPTER  XXI.    ON  RUPTURE  OR  HERNIA  IN  INFANTS 

There  sometimes  happens  to  infants  a  horrible  condition  against 
nature  and  commonly  called  rupture  whether  it  be  said  to  be  the  peri- 

17  This  early  example  of  animal  therapy  may  be  compared  to  the  use  of  dessicated 
thyroids  prescribed  for  the  same  condition  at  the  present  time. 


PAULUS  BAGELLARDUS  63 

toneum  (siphac)  ruptured  or  towards  the  groin  or  towards  the 
oxeum  or  in  part  of  the  breast  or  near  the  umbilicus,  but  the  proper  term 
for  it  is  hernia.  When  flatulence  or  wateriness  is  caused  by  fracture  of  the 
peritoneum  or  by  dilation  of  the  testicles  (didimi)  or  by  the  addition  of 
flesh  on  account  of  tumor  of  the  arteries  or  veins  adhering  to  the  testicles 
or  to  the  fleshiness,  it  is  also  called  ramex.  These  conditions  are  caused 
especially  by  fracture  and  happen  to  infants  from  excessive  crying  or 
from  fall  upon  the  stomach  or  from  flatulence  contained  in  the  intes- 
tines, although  it  can  happen  from  excessive  consumption  of  milk, 
especially  flatulent  or  watery  milk.  Although  this  condition  can  happen 
also  from  the  above-named  causes  not  only  to  infants  but  also  to  adults, 
[it  may  happen  to  adults  also  from  other  causes]  especially  upon  over- 
eating or  on  account  of  jumping  or  yelling  or  sexual  intercourse,  but  of 
these  not  a  word  for  the  present,  but  only  what  pertains  to  infants. 

If,  therefore,  hernia  is  caused  from  a  flatulent  cause,  then  a  tumor  of 
the  oxeum  is  apparent  and  as  regards  touch  the  condition  is  not  apparent 
nor  is  the  hard  condition  within  to  be  perceived,;  rather  indeed  are  the 
testicles  perceived  to  be  distinct  to  the  touch;  then  must  be  applied 
remedies  having  the  power  to  carminate  and  to  resolve  the  flatulence. 
Apply  an  ointment  to  the  infant  around  the  oxeum  and  pubes  with  oil  of 
dill  or  chamomile  or  white  garlic  alone  or  mixed  with  a  modicum  of  wax 
and  powder  of  cumin  or  calaminthe.  Or  take  the  powder  of  beans  and  mix 
with  some  of  the  said  oils  and  place  a  plaster  on  the  oxeum. 

But  if  it  is  caused  from  wateriness  alone,  let  it  be  relieved  with 
medicines  which  dry  up.  Dioscorides  said  that  bdellium  and  properly  so 
called  situlum,  when  mixed  with  human  saliva  until  it  is  an  ointment 
and  applied  around  the  oxeum,  and  Avicenna  said  that  bdellium  when 
softened  in  vinegar,  removes  watery  hernia.  Serapio  also  said  that  when 
the  place  of  the  hernia  or  fissure  is  opened  and  its  water  is  extracted,  a 
decoction  of  bdellium  is  an  appropriate  medicament. 

Of  the  compounds  for  the  first  intention,  namely 

for  flatulence: 

1$  stercoris  vaccae  sicci  et  cribrati  lb.  i 

succi  caulium  §vi 

ova  cruda  tria 

olei  communis  optimi  lb.  i 

sulphuris  3  i 

Grind  the  things  to  be  ground,  liquefy  those  to 
be  liquefied.  Then  in  the  dissolved  and  liquefied 
materials  place  eggs  and  dissolve  longer. 

With  this  plaster  you  will  cure  the  splenetic,  hepatic,  ruptured  and  gouty. 


64  PEDIATRICS  OF  THE  PAST 

Another  plaster  in  watery  and  flatulent  hernia : 

3  bdellii  gii 

pulveris  baccarum  Iauri  3i 

olei  Iaurini  quantum  sufficit  ad  inspissationem, 
et  si  addatur  seminis  ameos,  anisi  3ss. 

Oil  of  dill  also  is  more  efficacious,  and  if  the  hernia  is  caused  from  rupture, 
add  juice  of  ends  of  cypress  and  the  gluten  of  fish.  But  if  the  hernia  is 
caused  from  rupture  of  the  peritoneum,  whereby  the  intestines  and  the 
caul  descend,  then  introducing  the  intestines  and  the  caul  with  poultices 
made  from  a  decoction  of  chamomile,  melilot,  fenugreek  and  flax,  with 
the  body  supine  and  the  feet  and  legs  elevated,  apply  a  thread  drawn 
from  flax  and  boiled  in  ashes.  Then,  after  the  intestines  are  introduced 
and  these  measures  taken,  we  should  apply  a  band,  made  of  linen  cloth 
or  web  or  iron  or  wood,  or  a  quadrangular  ligature,  having  previously 
made  an  application  or  administration  of  cerate. 

But  among  the  things  which  are  taken  especially  by  way  of  the  mouth 
is  said  to  be  the  root  of  consolida  maior  (comfrey)  and  minor,  pulverized 
and  eaten  in  fritters  in  the  morning,  and  this  is  known  by  experience. 
Efficacious  also  is  the  bonifacia  herb  and  the  herb  which  is  called  trinity. 
Serapio  spoke  of  the  root  of  a  lily  of  a  third  species,  which  has  two  roots, 
one  above  the  other,  that  two  onions  should  be  boiled,  and  Dioscorides 
said  that  acorus  is  beneficial  to  infants  with  intestinal  rupture,  when 
given  from  above  (per  superius).  Galen  also  claimed  that  green  berries 
should  be  given  in  a  potion  ground  with  wine  of  their  own  juice  or  that 
the  place  be  plastered.  Yet  always  preceded  by  the  introduction  of  the 
intestines.  Serapio  also  said  that,  when  a  plaster  is  made  with  psyllium 
for  ramex  or  protuberance  of  the  umbilicus,  it  cures.  But  Fidelis  said 
that  every  fissure  is  cured  within  fifteen  days  by  leaves  of  the  fetid  water- 
hemlock  ground  and  made  into  a  plaster.  He  also  said,  concerning  the 
root  of  henna  which  is  a  plant  of  which  fibre  is  made,  whereby  fire  is 
enkindled,  that  when  ground  and  made  into  a  plaster  it  cures  the  fissure. 

Moreover  the  tried  remedies  are  true,  such  as  the  plasters  which 
follow : 

1^  acaciae  nucis  cypressi,  samsuci  ruthae,  ficcae, 
gallarum,  granatorum  lauri,  gummi  arabici, 
omnium  ana  3*x 

Let  them  be  ground  and  sieved  and  dis- 
solved in  fish  gluten  and  vinegar,  if  the  body 
be  large,  but  if  it  be  an  infant,  let  them  be 
boiled  with  the  mucilage  of  psyllium  and  a 
plaster  be  made,  yet  not  before  a  little  powder 
of  cypress  nut  is  quaffed. 


PAULUS  BAGELLARDUS  65 

A  second  plaster  used  in  practice  is: 

1$  succi  utriusque  consolidae,  Ianceolae,  plan- 
taginis,  corrigiolae,  caudae  equinae,  arrestae 
bovis,  pentaphilum,  sanguinariae  ana  lb.  ss. 

pulveris  gallarum,  boli  armeni,  sanguinis 
draconis,  cupularum  glandium,  corticum 
mediorum  castanearum,  virgae  pastoris,  Ien- 
ticulae,  masticis,  myrti,  mumiae  ana  3  iii 

olei  rosacei,  sepi  hircini  ana  Ib.i 

Let  them  be  mixed  and  to  a  slow  fire  let  an 
ointment  be  made  and  when  it  shall  have 
been  removed  from  the  fire,  let  it  be  con- 
stantly stirred  with  a  spatula,  until  the  whole 
is  incorporated. 

Another  tried  remedy: 

1$  ammoniaci,  resinae  pini  ana  partes  aequales 

Let  them  be  infused  in  strong  vinegar,  which  should  overtop  them 
by  a  finger's  width.  Afterwards  let  there  be  added  vinegar  almost  all, 
then  let  it  be  boiled  in  a  pot  on  the  fire  until  it  seems  to  cling  to  the 
fingers  and  after  it  is  spread  on  a  linen  strip,  and  then  after  it  cools  off, 
let  a  bit  be  broken  off  in  the  form  of  a  scud,  and  when  the  intestines  have 
been  reduced,  let  it  be  applied  to  the  place.  And  if  you  wish  it  to  become 
more  effective,  add  powder  of  nutgall  and  of  cypress.  When  you  wish  to 
remove  the  plaster,  place  upon  it  a  strip  with  hog's  lard,  and  let  it  not  be 
removed  until  it  softens. 

Another  plaster  for  intestinal  rupture: 

]$  radicum    trium    consolidarum,    faba    inversae, 

visci  quercini  ana  5  ii 

sanguinis  draconis,  boli  armeni,  gallarum,  nucis 
cypressi,  gummi  arabici  ana  3  i 

acaciae,  psidiae,  balaustiae  ana  3ss 

pilorum  Ieporis  3"i 

sepi  hircini  3  i 

picis  navalis  3  ii 

cerae  novae  3vi 

And  with  oil  of  rose  let  a  plaster  be  made. 

A  cerate  for  hernia  of  the  intestines: 

1$  scoriae  ferri  3yi 

momiae,  dragaganti,  gummi  arabici  ana  3  iii 

thuris,  acaciae,  sandaracae  ana  3  i  et  ss. 


66  PEDIATRICS  OF  THE  PAST 

gallarum  cypressi,  glutinis  piscium  ana  3  i 
visci  quercini  3"i 

gypsi  3ji 

resinae  5i  ss. 

Let  a  cerate  be  made  with  the  juice  of  com- 
frey,  vinegar  and  red  wax. 

Another  tried  cerate: 

1$  nucis     cypressi,     thuris,     acaciae, 
balaustiae,    sarcocollae,    sanguinis 
draconis,  sumach,  Iycii,  myrrhae      ana  3i 
terebinthinae  quantum  sufficit  ad 


Let  it  be  applied  to  the  rupture. 


inspissandum 


But  if  the  hernia  be  fleshy  or  be  caused  from  a  fattening  of  the 
arteries  or  veins  of  the  testicles  or  from  the  vertex,  the  cure  is  through 
the  removal  by  incision,  otherwise  it  cannot  be  cured.  But  if  it  be  caused 
by  rupture  near  the  umbilicus  or  the  latter  projects — a  condition  which 
frequently  obtains  in  infants,  but  especially  in  women  when  they  are 
pregnant,  Rasis  said  that  lupin  should  be  burned  with  bits  of  linen  cloth 
and  the  ash  be  mixed  with  wine  and  with  tow,  and  be  placed  upon  the 
affected  part.  Rasis  also  recommends  a  sitting  in  styptic  waters  and 
properly  in  water  of  a  concave  vessel.  Beneficial  also  is  the  plaster  pre- 
scribed above,  in  the  cure  of  hernia.  Likewise  beneficial  is  whatever  was 
said  above  concerning  the  egression  of  the  anus.  Moreover,  I  know  from 
experience  that  a  cerate  made  of  pix  navalis  with  powder  of  roses  and 
barks  of  pomegranates,  balaustia  and  myrtle  is  especially  beneficial. 


CHAPTER    XXII.    ON    ITCHING    OR    PUSTULES    OR    EXCORIATION 
OCCURRING  ON  THE  LEGS,  HIPS  AND  ENTIRE  BODY 

Infants  are  especially  made  restless  by  itching  or  pustules  or  excori- 
ation, occurring  on  the  legs  and  hips  and  sometimes  on  the  back  and 
entire  body.  And  the  cause  is  sometimes  corruption  of  milk  in  itself,  or 
its  sharpness,  or  corruption  of  milk  in  the  stomach  of  the  child,  although 
the  infants  are  more  mature,  namely  taking  food,  masticated  by  the 
nurse  or  mother  or  not  masticated.  Now  of  these  blisters  or  pustules, 
there  are  some  which  are  red,  some  yellow  and  of  violent  pain,  some 
black.  If  they  are  black,  they  signify  death  accompanied  by  fever.  Now 
the  cure  [original  has  circa  which  is  interpreted  as  a  misprint  for  cura]  of 
pustules  and  of  excoriation — and  even  of  fissures  if  there  are  any — if  the 
infant  is  nursing,  is  effected  only  with  the  correction  of  the  milk  of  the 


PAULUS  BAGELLARDUS  67 

nurse  or  mother.  But  if  the  infant  cannot  take  anything  by  way  of 
swallowing,  we  should  administer  those  remedies  which  have  the  power  to 
destroy  the  sharpness  of  the  blood  and  also  of  the  choler.  To  be  recom- 
mended, according  to  the  opinion  of  Rasis,  is  a  decoction  of  dates  or  figs 
with  water  of  fennel,  for  driving  out  the  sharpness  of  the  humors  from  the 
center  to  circumference.  And  when  the  matter  has  been  drawn  toward 
the  surface,  we  should  bathe  him  in  boiled  water,  which  contains  leaves 
of  roses  and  myrtle.  When  the  boy  is  removed  from  the  water,  smear 
him  with  oil  of  roses,  and  if  the  wounds  are  dry,  with  oil  of  violets. 
If  the  itching  of  the  infant  has  lasted  more  than  seven  months,  bathe 
him  in  water,  in  which  have  been  boiled  dry  violets,  and  excorticated 
barley,  marshmallow  and  leaves  of  the  gourd  (cucurbita),  but  do  not 
apply  any  ointment;  and  give  the  nurse  the  juice  of  fumaria  and  yellow 
mirabelle. 

Now  if  any  ulcers  appear  on  the  legs  due  to  urine,  apply  after  the  bath 
almonds  or  animal  charcoal  or  roses  pulverized  with  barley  meal.  Accord- 
ing to  the  opinion  of  Avicenna  myrtle  is  to  be  recommended,  or  its 
powder  pulverized  sprinkled  thereon,  or  orris  root  or  ground  roses  or 
cyperi,  or  barley  meal  or  lentil  meal — all  pulverized  together  or  individ- 
ually. Isaac  said  that  if  on  account  of  saltiness  there  has  occurred  a 
stinging  sensation  in  the  legs  or  pain  some  place,  let  there  be  sprinkled 
thereon  wheat  meal  well  citronized  or  powder  of  roses  not  very  fine,  or 
fine  powder  of  tragaganth.  I  know  this  from  experience,  that  oil  of  roses 
made  into  a  lotion  with  water  of  roses,  mixed  with  egg  albumen,  wonder- 
fully relieves  excoriation  of  the  legs  or  hips  of  infants  due  to  the  sharpness 
of  urine.  A  tried  remedy  also  is  powder  of  myrtle  with  egg  albumen  and 
applied  as  an  ointment  to  the  injured  parts.  It  is  also  in  practice  to 
remove  the  root  of  the  white  vine  or  its  tops  and  grind  them  with  salt 
and  apply  thereon. 

But  I  know  clearly  from  experience  that  in  itching  and  fissures  of  the 
legs  and  hips  in  boys,  nay  even  in  youths  and  old  men,  always  premiss- 
ing  a  purging  of  the  body,  an  application  made  with  the  ointment  of 
white  lead  made  into  a  lotion  with  oil  of  roses  and  litharge  of  gold 
wonderfully  removes  the  ailment. 

But  I  intend  to  add  something  brief,  which,  even  if  it  be  small  and 
unimportant,  nevertheless  is  full  of  virtue,  not  only  for  nursing  infants 
and  their  excoriations,  but  even  for  nurses  having  fissures  in  the  nipples 
of  their  breasts,  and  that  is  as  follows : 

1$  farinae  amidi  5  v 

aquae  rosarum  quantum  sufficit  ad  inspissationem 

Let  a   liniment  be 
made,  etc. 


68  PEDIATRICS  OF  THE  PAST 

APPENDIX.    CERTAIN    DISEASES    NOT    MENTIONED    BY    THE  AUTHOR 

Besides  the  diseases  already  described  above,  let  us  add  sneezing, 
hiccup,  difficulty  of  breathing,  terror  of  dreams,  paralysis  accompanied 
by  wasting  away,  or  no  immoderate  thinness,  weaning  of  infants  and  its 
regimen. 

For  continually  sneezing,  therefore,  and  dripping  from  the  nostrils, 
apply  to  the  nostrils  ocimum  ground  and  sifted,  in  such  a  manner  that  it 
is  drawn  in  with  the  breath,  or  snuff  it  in.  This  should  be  done  when  there 
is  not  present  an  abscess  of  the  cerebrum,  but  where  it  happens  from 
some  other  cause.  But  if  it  begins  with  heat,  then  apply  to  its  head  leaves 
of  purslane  or  shavings  of  cucurbita  mixed  with  barley  meal  in  oil  of  roses 
and  an  egg  yolk,  and  apply  it  all  to  the  head,  but  the  oil  of  roses  also  to 
the  nostrils  either  with  a  feather  or  some  slender  thing  which  is  not  at  all 
offensive  to  the  nostrils.  Stork  feathers  should  be  kept  in  the  house  and 
thus  it  will  be  impossible  for  infants  to  sneeze  successfully.  Also  compress 
the  great  angles  of  each  of  the  eyes  adjacent  to  the  nostril  and  you  will 
check  the  sneezing — it  is  a  secret  of  nature. 

For  hiccup,  which  in  infants  is  generally  caused  by  no  slight  over- 
nourishment,  induce  nausea  and  vomiting  and  allow  it  to  take  no  food 
for  three  hours  after  the  vomiting,  but  rather  induce  slumber.  Also  smear 
the  stomach  with  oil  of  mastic  or  take  nux  indica  and  give  it  to  the  infant 
ground  and  tempered  with  sugar.  If  it  is  caused  by  cold  on  the  stomach, 
make  warm  applications  on  the  stomach  with  oil  of  laurel  or  of  dill  or 
with  the  seed  thereof  ground  and  with  mint  juice.  If  the  hiccup  arise 
from  hunger  or  lack  of  food,  take  oil  of  violets  or  roses  with  the  juice  of 
endive  or  of  other  herbs  which  have  the  power  to  cool  and  to  moisten, 
and  tempered  with  woman's  milk  smear  on  the  stomach  thoroughly  and 
gently.  Also  give  milk  well  tempered,  namely  as  will  be  that  of  a  tem- 
perate woman,  and  other  useful  things  restore  the  strength. 

For  relieving  difficulty  of  breathing  (which  is  called  dyspnea), 
together  with  snoring  breathing,  take  as  much  as  you  wish  of  flaxseed  and 
grind  it  up,  then  temper  it  with  honey  and  give  to  the  infant  warm. 
Also  drop  hydromel  carefully  into  the  mouth,  and  if  this  does  not  have 
the  desired  effect,  dip  the  middle  finger  in  oil  and  smear  on  the  tonsils. 
But  depress  the  root  of  the  tongue  inside,  induce  vomiting  and  when 
vomiting  takes  place  he  will  be  forthwith  cured.  But  if  the  disease 
becomes  more  severe  and  the  praecordia  obstructed,  take  cotton  or  these 
seeds  unwrapped  and  give  them  crushed  with  a  broiled  yolk  to  the 
infant  to  suck.  But  if  with  the  difficulty  a  flow  of  the  bowels  follows, 
administer  syrup  of  myrtle  boiled  with  honey  or  dates  boiled  with 
wheat  meal  and  milk. 

Terrifying  dreams  are  wont  sometimes  to  make  infants  restless,  and 
these  are  due  to  superabundance  of  nourishment.  Sleep,  therefore,  should 


PAULUS  BAGELLARDUS  69 

be  secured  thus.  First  let  the  nurse  take  care  lest  she  put  the  infant  to 
sleep  immediately  after  feeding.  Then  give  the  infant  a  little  honey  to 
lick,  in  order  that  the  things  which  are  more  difficult  to  digest  may  the 
more  easily  be  digested  and  the  recrements  be  sent  to  the  intestines  and 
the  belly.  Give  powder  of  diamoschus  or  of  pliris  with  mascus  and  milk 
to  suck.  Some  use  theriaca  with  milk;  this  I  am  unwilling  to  prescribe, 
because  it  is  not  suitable  for  infants  on  account  of  its  strength. 

For  paralysis  together  with  a  wasting  away.  First  the  nurse  must  be 
strengthened  and  built  up  on  dry  foods  and  foods  which  give  much 
warmth,  but  let  her  refrain  absolutely  from  fish,  milk,  greens  and  fat 
meat  and  pork,  and  let  her  not  use  diluted  wine.  Before  the  infant  is 
nursed  wash  it  with  warm  sulphurous  water  or  other  astringents,  and 
then  smear  it  with  oil  of  castor  or  of  costos.  Take  also  1  dram  of  wax 
and  1  ounce  of  euphorbium,  and  this,  worked  up  together  and  tempered 
with  oil,  apply  to  the  infant's  spine  in  the  form  of  a  plaster. 

For  moderate  thinness,  use  a  bath  of  water,  in  which  the  head  and 
feet  of  a  ram  have  been  boiled  until  the  flesh  separates  from  the  bones 
and  shows  itself  of  its  own  accord,  and  in  this  bath  let  the  infant  be 
cleansed  as  often  and  as  thoroughly  as  will  be  necessary,  and  carefully 
removed  from  the  bath.  Then  it  should  be  smeared  with  this  ointment. 

]$  butyri  recentis,  olei  violati  et 

rosacei  singulorum  5n 

axungiae  porci  5  vi 

cerae  candidae  5iv 

Melt  these  together,  make  into  an  oint- 
ment and  use  in  manner  described. 

For  immoderate  fevers  or  heats.  If,  therefore,  fever  visits  the  infant, 
the  first  duty  of  the  nurse  will  be  to  feed  on  those  foods  which  cool  and 
moisten.  Then  give  the  infant  the  following:  juice  of  pomegranate, 
neither  bitter  nor  sweet,  but  medium,  and  if  you  haven't  this,  prepare  it 
artificially,  that  is,  with  sugar.  Water  of  cucurbita  and  of  flowers  of 
violets,  of  grass  and  of  purslane,  sometimes  with  sugar,  sometimes  alone 
are  also  employed.  It  will  also  be  beneficial  to  induce  sweats  in  the 
infant.  Take  the  crushed  pith  of  a  green  reed,  and  smear  it  on  the  head 
and  feet,  and  cover  the  infant  itself  with  clothing.  Likewise  anoint  the 
forehead  with  oil  of  roses  mixed  with  poplar  ointment;  but  to  the  heart 
and  to  the  liver  apply  a  poultice  made  of  appropriate  ingredients, 
namely  endive,  lettuce,  hepatic  plantain  and  roses. 

And  if  the  voice  has  been  obstructed,  because  of  the  heat  or  the 
constriction  of  the  bowels — which  is  generally  wont  to  happen — give  the 
juice  of  brassica  to  drink,  or  drop  it  into  the  previously  mentioned  acorn, 
which  should  be  inserted  in  the  anus. 


7o  PEDIATRICS  OF  THE  PAST 

Now,  let  us  discuss  weaning,  with  which  we  shall  bring  to  an  end  the 
diseases  of  infants.  Therefore,  for  the  end  of  infancy,  which  is  the  begin- 
ning of  boyhood,  we  must  show  how  infants  are  to  be  weaned  and  at  what 
period.  When  the  body  is  solid,  the  more  solid  foods  should  be  used,  and 
the  more  enticing  morsels  with  honey-water  or  honey-wine  or  milk  or 
sweet  wine;  then  you  will  give  eggs  to  suck  also  and  diluted  wine  to 
drink.  But  when  the  boy  already  takes  more  solid  food,  then  gradually 
and  slowly  let  him  become  disaccustomed  to  the  breasts.  But  if,  after  he 
is  weaned,  he  succumbs  to  a  disease,  let  him  be  put  back  on  milk  again, 
and  then  when  the  disease  has  left  him,  the  little  body  must  be  built  up 
again  and  so  weaned  anew. 

Now  the  mode  of  living  in  weaned  children  is  this:  they  must  be 
relaxed  and  vigorously  exercised;  lighter  foods  and  good  juices  must  be 
supplied.  Yet  the  temperate  body  must  abstain  from  excess  wine,  for 
wine  in  warm  and  humid  temperatures  fills  the  head  with  vapors.  Nor  do 
I  think  they  should  be  prohibited  cold  drinks;  wherefore  let  them  use  the 
best  selected  water.  From  the  seventh  year  on  they  must  be  educated 
and  should  be  entrusted  to  kind  and  gentle  preceptors.  For  many,  edu- 
cated in  evil  customs  and  induced  by  intemperance  and  license  (which 
renders  many  worse),  corrupt  good  dispositions,  just  as  on  the  other 
hand,  some,  born  with  a  vicious  body,  by  a  more  prudent  life  and 
timely  exercise  compensate  for  many  deficiencies  of  nature. 


BARTHOLOMAEUS  METLINGER 

r-1491] 

THE  year  following  the  publication  of  the  work  of  Bagellardus 
a  work  on  the  diseases  of  children  appeared  in  German.  This 
second  pediatric  incunabulum  is  the  work  of  Bartholomaeus 
Metlinger,  printed  by  Gunther  Zainer  of  Augsburg  and  dated 
December  7,  1473.  Metlinger  was  the  son  of  a  physician,  Meister 
Peter  Metlinger,  who  lived  in  Augsburg.  He  is  supposed  to  have 
died  in  1491  or  1492.  Sudhoff l  gives  an  account  of  him  and  Huber2 
also  mentions  Metlinger  in  reviewing  SudhofFs  article.  He  has 
also  been  studied  by  Ludwig  Unger3  and  Richard  Landau.4 
Hain  lists  four  editions  of  Metlinger's  book,  numbers  11 127, 
1 1 128,  1 1 129,  and  1 1 130  in  the  "  Repertorium.,,  Various  references 
to  the  Metlinger  editions  are  sometimes  wrong.  Unger  has  the 
"Schauren"  edition  dated  1457  when  it  should  be  1497. 

The  first  edition  was  printed  in  Augsburg  in  1473  or  as  the 
book  itself  states:  "Geschehen,  als  man  zalt  nach  Christi  Geburt 
tauset  vierhundert  und  in  den  lxxiii  Jar,  an  dem  achten  den  Tag 
Sant  Endris  des  zwolff  Boten."  (December  7,  1473.)  This 
was  a  folio  of  twenty-seven  leaves  printed  by  Gunther  Zainer. 
Mr.  C.  Perry  Fisher  lists  it  thus: 

Metlinger  Bartholomaeus.  [Regiment  der  jungen  Kinder]  [F.  ia:] 
[W]  Ann  nach  ansehung  gotlicher  //  und  menschlicher  o[r]denung  .  .  . 
[F.  27b:]  da  //  mit  sich  das  vierd  capitel  endet  v[o]n  dar  dur  //  ch  dises 
buchlin  Dar  von  got  dem  almechti  //  gen  Er  wurd  w[o]n  lob  gesagt  sey 
und  seiner  //  werde  [n]  muter  der  iungfrauwe[n]  marie  Gesche  //  hen 
als  ma[n]  zalt  nach  xpi  geburt  tauset  vier  //  hundert  und  in  de[n]  lxxiii. 
jar  an  dem  achten  //  den  tag  sant  End[r]  is  des  zwSlfF  boten.// 

1  Sudhoff,  K.  Deutschen  medizinischen  Inkunabeln,  Leipzig,  1908,  pp.  38-43. 

2  Huber.  Miincben  med.  Wchnscbr.,  xxviii,  1908. 

3  Unger,  L.  Das  Kinderbuch  des  Bartholom&us  Metlinger,  Leipzig  and  Wien, 
1904,  p.  45. 

4  Landau,  R.  Geschichte  der  Kinderheilkunde,  Wien.  Med.  Presse.,  Wien,  xxviii, 
1904. 

7i 


72  PEDIATRICS  OF  THE  PAST 

The  next  year  Johan  Baemler  printed  the  second  edition. 
Some  of  the  leaves  of  this  were  printed  at  one  time  and  some  at 
another.  They  bear  different  dates,  as  witness  the  following 
examples: 

1 1 128:  "Gedrucks  uh  volendet  von  johi  Bamler  zu  Augspurg 
am  sant  Augusteins  tag  als  man  zalt  nach  rpi  geburt  tausent 
vierhundert    and    in    dem    lxxiiii    Jar."     (August    28,    1474.) 

Godriche  zu  Augsburg  von  johanne  Baemler  anno  in  dem 
lxxiiii  Jar. 

The  third  edition,  Hain  1 1 129,  a  small  quarto  of  twenty-three 
leaves,  also  came  from  the  press  of  Baemler,  in  1476,  "Gedruckt 
.  .  .  Montag  vor  sant  Laurenzen  tag  anno  J  C  in  dem  lxxvi  jare." 
(August  5,  1476.) 

The  fourth  edition,  Hain  1 1 1 30,  of  Metlinger  was  printed 
by  Hans  Schauren  in  1497,  "Und  saligklich  volendet  am  Freitag 
vor  martini.  Als  man  zalt  nach  der  gepurt  Cristi  unsers  Iieben 
herren  Tausent  vier  hundert  und  in  dem  sib  und  niintzugisten 
jar."     (November  10,  1497.) 

The  fifth  edition  is  dated:  "Im  iubel  iar  als  man  ze  let  nach 
Christi  unsers  herren  Geburt.  Mccccc  iar."  (February  13,  1500.) 
This  was  by  Hans  Schauren. 

Sudhoff  gives  two  reprints  in  the  sixteenth  century.  One  is 
dated  February  10,  151 1,  printed  by  "Hansen  Schensperger  den 
Jungen  zu  Augspurg"  and  the  other  dated  "Am  en  dedie  Jahres- 
zahl  M.D.xxxi."  This  edition  is  preceded  by  "  Die  Heymlicheytenn 
Alberti  Magni"  and  gives  Metlinger's  name  as  Merlinger.  This 
edition  was  reprinted  in  153 1. 

Sudhoff  gives  a  short  account  of  the  contents  of  the  book, 
which  starts  off: 

Wie  erst  geborne  kind  vncz  bis  zu  den  syben  jaren  ju  gesuntheit  auch 
jn  kranckeiten  gehalten  werten  sollen  Zu  lob  got  dem  allmachtigen  and 
seiner  werden  muter  Marie  der  junckfrowen  einem  Gemeinen  nucz  zu 
gut  und  mich  selbs  ju  erhetung  eigner  sinnlichkeit  zu  iiben. 

The  sources  of  the  work  are  to  be  found  in  Galen's  first  book 
"De  regimen  sanitates,  the  canon  of  Avicenna,  the  CoIIiget  of 
Averroes,  the  Pantegni  of  Constantine  and  the  Continens  of 
Rhazes."  In  spite  of  the  fact  that  the  book  was  written  at  a  time 
when  it  was  the  custom  to  follow  slavishly  the  writings  of  the 
ancients   and   the   Arabians,   the   Renaissance   was   under   way 


TVti  man  fy  tyaltt n  vnb  erjiec^ert  (ol  *  Ort 
trcr  gepurt  bijj  (y  ju  jtcn  ta&n  t  omen* 


Fig.  7.     Deutsche  Burgerstube  im  15.  Jahrhundert. 
Titelbild  des  Metlingerschen  Kinderbucbs,  Augsburg  1497;  Originalgrotte. 


Title  page  of  the  fourth  edition  of  Metlinger. 


74  PEDIATRICS  OF  THE  PAST 

and  so  Metlinger  added  such  things  as  he  himself  had  found  useful 
or  thought  of  value.  The  book  is  one  of  the  best,  if  not  the  best, 
of  the  early  works  on  pediatrics.  The  first  chapter  gives  the 
general  rules  for  the  newborn  and  this  and  the  second  chapter 
deal  with  nursing,  the  choice  of  a  wet  nurse  and  weaning.  These 
are  distinctly  modern  in  feeling.  In  other  words  we  advise  much 
the  same  care  today  as  Metlinger  did  in  the  fifteenth  century. 
Details  may  differ  but  the  resemblance  to  the  modern  welfare 
pamphlets  is  striking. 

An  interesting  adumbration  of  glandular  therapy  is  found  in 
the  recommendation  of  eating  the  udder  and  bag  of  goats  and 
sheep  that  have  given  milk.    (Soranus  made  the  same  suggestion.) 

In  the  third  chapter  Metlinger  begins  at  the  head,  works 
downward  and  then  takes  the  general  diseases.  Now  the  thing  to 
be  noted  is  that,  as  in  the  literature  of  all  times  and  places,  when 
the  author  writes  what  he  really  knows,  he  does  very  well;  when 
he  speculates  about  things  which  he  does  not  know,  he  is  usually 
absurd  or  wrong.  This  is  a  characteristic  of  present  day,  as  well 
as  past,  medical  writing.  When  Metlinger  says  that  scurf  is 
"overflowing  of  the  blood  and  a  moisture  from  the  inside  of  the 
head  outwards,"  he  might  in  one  sense  be  taken  to  be  correct, 
but  it  is  pretty  certain  that  he  thought  the  fluid  inside  of  the 
skull  came  out.  But  his  therapy  is  sound :  cut  the  hair,  soften  the 
crusts  with  a  poultice,  use  a  stimulating  ointment  following 
the  cleansing,  and  for  special  cases  apply  mercury  and  sulphur 
externally.  Quite  modern  indeed. 

In  considering  convulsions  he  noted  that  when  the  child  is 
affected  soon  after  birth  it  generally  dies. 

In  running  ear,  his  method  of  washing  out  the  ear  or  of 
cleaning  it  with  cotton  and  the  use  of  astringents  such  as  alum 
and  tannic  acid  (acorns)  in  an  antiseptic  solution  (diluted 
wine  i.e.,  diluted  alcohol)  must  have  been  followed  by  good 
results. 

His  explanation  of  jaundice  suggests  that  he  would  have 
made  an  excellent  advertising  writer  for  a  present  day  manu- 
facturer of  gland  products. 

The  third  chapter  treats  various  diseases:  meningitis,  hydro- 
cephalus, sleeplessness,  cramps,  paralysis,  running  ears,  inflamma- 
tion of  the  eyes,  swelling  of  the  neck,  diseases  of  the  mouth, 
bronchitis,  diseases  of  digestion,  jaundice,  dysentery,  constipa- 


BARTHOLOMAEUS  METLINGER  75 

tion,  worms,  abdominal  pain,  umbilical  and  inguinal  hernia, 
stone,  ulcers  of  the  skin,  fever,  erysipelas,  measles  and  smallpox. 

The  fourth  chapter  considers  the  child  from  the  time  it 
learns  to  walk  up  to  the  seventh  year;  its  physical  and  moral 
upbringing,  eating,  drinking,  bathing  and  exercise.  The  education 
is  to  begin  at  six  years  of  age.  Muss  (Brei)  or  mush  and  milk  is 
the  chief  diet  in  the  early  years  and  other  articles  are  added  as 
the  child  grows.  Wine  is  not  given  to  healthy  children  under 
seven;  to  girls  it  may  be  given  at  twelve  years  and  to  boys  at 
fourteen  years. 

The  translation  which  follows  is  the  Unger  text  somewhat 
freely  rendered.  The  translator  is  indebted  to  Prof.  Karl  Sudhoff 
for  help  in  rendering  some  of  the  old  medical  terms  which  Unger 
left  in  the  original. 

After  a  short  introduction  in  which  the  author  names  himself 
and  explains  that  he  feels  called  upon  to  give  his  advice  to  fathers 
and  mothers  who  do  not  understand  how  to  care  for  children  in 
health  and  in  sickness,  the  author  begins  his  presentation  as 
follows : 

All,  to  whom  this  book  comes  to  hand,  and  who  are  experienced 
in  the  art  of  medicine,  I  earnestly  beg,  if  they  find  anything  blameworthy 
in  it,  to  criticize  it  in  a  brotherly  way,  so  that  the  blameless  part  may 
come  to  be  used  and  Almighty  God,  who  has  created  the  art  of  medicine 
and  all  things,  may  be  praised  and  honored.  And  that  the  material  in 
this  little  book  may  be  the  easier  to  find  I  have  divided  it  into  four 
parts  or  chapters. 

I.  The  first  tells  how  one  should  care  for  new  born  children  until 
they  are  able  to  walk  and  talk. 

Constantinus  says:  After  the  child  is  born  the  midwife  shall  cover 
her  finger  with  rose  or  other  honey,  put  it  in  the  child's  mouth  in  such  a 
manner  that  it  covers  the  jaws,  gums  and  tongue  so  that  if  there  is  any 
to  be  dissolved  it  will  be  dissolved.  Then  the  navel  should  be  cut  four 
fingers  long  and  tied  both  on  the  side  of  the  child  and  that  of  the  mother 
so  that  it  does  not  bleed.  Then  one  should  sprinkle  the  child  with  finely 
pulverized  salt  but  not  the  mouth,  nostrils  or  face.  It  is  good  to  mix  the 
salt  with  equal  parts  of  powdered  rose,  wild  marjoram  and  whortleberry 
flowers.  Averroes  and  Avicenna  are  of  the  opinion  that  salt  bites  and 
that  the  child  should  be  rubbed  with  acorn  oil.  Such  salting  or  anointing 
cleans  and  strengthens  the  external  members  so  that  the  child  may  be 
handled  with  the  least  care  whether  it  be  cold  or  hot,  severe  or  mild 
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Title  page  of  the  1549  edition  of  Metlinger  and  a  rendition  of  the  pediatric  part  of 
Louffenburg's  poem  "Versehung  des  Leibs." 


BARTHOLOMAEUS  METLINGER  77 

good  as  you  have  just  heard.  After  that  one  should  wash  the  child,  in 
summer  with  tepid,  in  winter  with  warm  water.  Then  one  should  sprinkle 
the  navel  with  a  powder  of  aromatic  flowers  (Dragon's  blood  and 
myrrh)  and  lay  over  it  a  little  pad  wet  in  rose  oil.  This  should  be  done 
as  often  as  necessary  when  the  child  is  bathed;  if  the  midwife  does  other- 
wise she  should  be  fined,  such  is  an  opinion.  After  3-4  days  when  the 
navel  begins  to  loosen,  one  should  take  care  that  it  be  not  wantonly  torn 
off.  When  it  has  separated  one  should  sprinkle  the  navel  with  a  powder 
of  soles  or  calves'  heels  which  makes  a  well  conditioned  navel.  If  the 
child  should  bleed  from  a  torn  navel  cord  it  should  be  sprinkled  with 
armenian  bolus,  which  is  a  red  earth  from  the  apothecary's,  which  will 
form  a  crust  which  should  be  allowed  to  separate  of  its  own  accord. 

In  the  first  half  year  the  child  should  be  bathed  daily,  a  daughter 
with  warmer  water  than  a  son.  The  ears  should  be  stopped  with  cotton 
when  it  is  bathed  so,  as  Avicenna  says,  that  the  water  does  not  enter  the 
ear.  One  should  stroke  the  little  abdomen  downwards  and  touch  the  anus 
to  prevent  stool  and  urine.  When  the  child  cries  or  trembles  in  a  bath 
even  though  it  be  warm,  it  should  be  taken  out.  It  should  be  bathed  until 
the  body  is  red  and  the  best  time  to  bathe  it  is  after  a  long  sleep.  For  an 
hour  before  the  bath  it  should  neither  eat  nor  drink  and  if  it  should  go  to 
sleep  after  the  bath  it  should  be  placed  with  the  little  head  high  upon  a 
small  pillow  so  that  the  shoulders  lie  a  little  high.  Above  all  things  one 
should  see  that  the  head  does  not  lie  deep  and  hard  and  if  the  women  will 
not  give  up  their  old  bad  habits  one  should  not  permit  this  as  much  harm 
can  come  out  of  it  as  running  and  bad  ears  and  misshapen  heads.  The 
child  should  lie  with  the  body  stretched  out  and  the  head  and  body 
should  be  covered  according  to  whether  it  is  warm  or  cold.  Furthermore, 
the  child  in  the  first  six  weeks  should  be  kept  in  a  half-darkened  room  and 
care  should  be  taken  that  neither  sun  nor  moon  touch  it  and  also  that 
neither  cats  or  any  other  animal  come  near  it  and  it  should  be  protected 
from  fright.  When  the  child  is  picked  up  it  should  be  taken  by  the  chest 
and  not  the  abdomen  and  the  other  hand  should  be  placed  under  the 
back.  After  the  bath  one  should  drop  violet  oil  into  the  nostrils  to  soften 
the  nasal  mucus  and  cause  it  to  run  out  of  the  nose. 

One  should  also  know  that  after  the  bath,  before  the  child  is  wrapped 
up,  the  legs  should  be  bent  backwards  and  also  the  feet  brought 
forward  to  the  head,  especially  in  boys  so  that  their  joints  will  be  the  more 
supple.  The  joints  should  be  softly  rubbed  and  if  there  is  anything  to 
stretch  it  should  be  stretched,  the  arms  alongside  the  body  and  the  legs 
likewise  and  if  the  child  has  misshapen  joints  or  limbs  as  Galen  tells, 
they  should  be  anointed  with  rose  oil  after  the  bath  and  placed  in  the 
best  position  and  if  necessary  they  should  be  bound  up.  The  eyes  should 
be  covered  frequently  with  a  dark  green  cloth  to  strengthen  the  sight. 
One  should  beware  of  cold  according  to  the  season  of  the  year. 


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First  page  of  Metlinger's  work. 


BARTHOLOMAEUS  METLINGER  79 

After  the  first  half  year  the  child  may  be  bathed  every  second  day  and 
later  the  third  or  fourth,  according  to  the  increase  in  age.  One  should 
not  bathe  children  too  much  as  is  generally  done  as  it  is  not  necessary. 
When  they  cry  without  any  apparent  cause  they  should  be  laid  on  their 
abdomens  and  covered  with  warm  clothes  and  so  quieted  and  whoever  is 
caring  for  the  child  should  consider  such  things  and  do  whatever  is 
necessary. 

Healthy  children  have  good  habits  and  do  not  complain.  When 
children  whine  or  cry  they  are  unhealthy,  therefore,  one  should  consider 
their  health  and  care  for  them  in  such  a  manner  that  they  contract  no 
bad  habits.  One  should  with  great  industry  see  that  they  do  not  have 
unusual  movements  and  if  they  whine  or  cry  or  are  angry  one  should 
take  care  to  see  why  they  are  so  and  try  to  prevent  it.  Children  cry 
either  because  they  have  pain,  or  are  troubled,  or  because  they  are  wet 
with  urine,  or  wish  to  go  to  stool,  or  they  are  too  hot  or  too  cold,  or  have 
too  many  clothes  on,  or  have  Iain  too  long  or  they  are  lying  in  unclean 
covering.  All  these  things  should  be  considered  and  whatever  is  necessary 
should  be  done  for  the  child.  Above  all  things  their  linen  should  be  kept 
clean.  When  one  would  comfort  or  quiet  a  child  it  can  be  done  in  three 
ways.  First,  put  the  mother's  breast  in  its  mouth  as  when  one  gives  the 
child  the  breast  all  its  troubles  are  put  to  one  side;  secondly,  with  song,  for 
a  mild  voice  reaches  its  heart; and  thirdly,  that  one  softly  rocks  the  cradle. 

It  also  should  be  understood  that  when  children  begin  to  creep  around 
the  floor  and  to  reach  after  things  one  should  make  for  them  a  little  pen 
of  leather  so  that  they  do  not  hurt  themselves.  And  finally  one  should 
never  leave  them  long  and  unprotected. 

The  second  chapter  tells  how  one  should  nurse  and  nourish 
children  and  when  their  own  mother  cannot  nurse  them  what 
the  conditions  of  a  wet-nurse  should  be  and  how  and  when  infants 
should  be  weaned.  Metlinger  begins  this  chapter  with  a  discussion 
with  Avicenna  on  the  formation  of  the  milk  out  of  the  blood  of 
the  mother  which  runs  to  the  breast  through  the  vessels  provided 
for  this  and  how  the  milk  is  formed  and  then  he  continues : 

In  the  first  fourteen  days  it  is  better  that  another  woman  suckle  the 
child  as  the  milk  of  the  mother  of  the  child  is  not  as  healthy,  and  during 
this  time  the  mother  should  have  her  breasts  sucked  by  a  young  wolf  or 
the  milk  should  be  sucked  off.  When,  however,  the  mother  will  nurse  the 
child  from  the  first  day  then  one  should  put  a  small  amount  of  honey  or 
rose  honey  in  the  mouth  so  that  the  milk  injures  it  less.  And  now  if  one 
will  have  a  child  nursed  the  wet-nurse5  should  first  milk  the  breasts  so 

a  The  term  nursing  woman  might  be  used  for  wet-nurse  as  it  may  refer  to  the 
mother  as  well  as  a  wet-nurse  as  we  use  the  term. 


80  PEDIATRICS  OF  THE  PAST 

that  the  watery  part  runs  from  it  and  then  give  the  child  to  suck.  It 
must  be  considered  that  if  the  child  is  to  be  healthfully  nourished 
both  wet-nurse  and  the  child  should  be  well  ordered  and  live  properly 
because  where  this  is  not  done  all  sorts  of  diseased  conditions  may  arise. 
The  best  wet-nurse  for  a  healthy  child  is  its  own  mother  but  in 
sickness  or  where  the  milk  does  not  come  in  or  for  other  reasons  the 
mother  cannot  nurse  her  child,  one  should  choose  a  wet-nurse  who  has 
the  following  appearance  and  habits.  She  must  neither  be  too  young  nor 
too  old.  She  should  be  not  younger  than  twenty  years  of  age  and  at 
twenty-five  she  is  at  her  best.  Her  own  child  should  be  over  six  weeks 
old.  It  is  best  when  she  has  suckled  two  or  three  other  children.  The 
time  of  her  delivery  should  not  have  been  too  soon  either  with  this  child 
or  with  the  others.  She  should  be  well  built;  her  face  healthy  in  appear- 
ance, tanned;  and  she  should  have  a  strong  thick  neck,  strong  broad 
breasts,  not  too  fat  and  not  too  thin  but  preferably  well  formed  and 
fleshy  and  that  do  not  hang  down,  not  too  small  but  average  good  size. 
The  wet-nurse  should  have  good  praiseworthy  habits.  She  should  not  be 
easily  frightened  or  worried  and  not  small-minded  or  prone  to  anger. 
She  should  be  industrious  and  careful  with  the  child.  She  should  take 
care  that  she  does  not  become  pregnant  as  this  is  dangerous  to  the  child, 
as  the  best  blood  of  the  pregnant  woman  goes  to  the  fetus.  In  such  cases 
the  child  should  be  weaned  just  as  if  the  wet-nurse  herself  were  sick. 
The  less  the  child  nurses  at  this  time  the  better  it  is  for  the  child.  Also 
the  wet-nurse  should  not  be  diseased. 

Metlinger  gives  the  following  observations  on  the  characteris- 
tics of  good  milk: 

The  milk  should  be  white,  sweet  and  without  any  foreign  taste.  It  is 
better  to  have  too  much  than  too  little.  It  should  be  averagely  good,  not 
fluid  and  watery  and  not  thick  and  sticky.  If  a  drop  of  milk  is  placed 
upon  the  finger  nail  and  it  sticks  to  it,  it  is  too  thick,  if  it  runs  off  it  is  too 
thin,  but  if  it  stays  on  the  nail  and  does  not  stick  then  it  is  all  right. 
A  little  milk  may  be  placed  in  a  glass  and  a  little  powdered  myrrh  mixed 
in  it  and  let  it  stand  about  an  hour.  If  the  thick  part  at  the  bottom  is 
more  than  the  watery  part  above,  the  milk  is  too  thick.  Conversely,  if  the 
watery  part  is  more  then  is  it  too  thin,  but  if  both  are  about  the  same 
then  is  the  milk  of  the  right  consistency.  If  the  milk  is  too  thick  or  too 
thin  this  advice  should  be  followed  until  it  is  of  average  quality. 

If  the  milk  is  too  thick  the  wet-nurse  should  conduct  herself  thus. 
She  should  eat  less  and  she  should  use  saffron  in  all  her  food.  Pea  soup, 
cheese  soup,  meat  soup  and  oatmeal  gruel,  eggs  and  the  like  are  for  her 
healthful.  She  should  avoid  tender  flesh,  pastries,  fish,  cheese  and  her 
drink  should  be  delicate  white  wine  mixed  with  water.  She  should  avoid 


BARTHOLOMAEUS  METLINGER  81 

beer  but  may  drink  pea  soup  made  yellow  with  saffron  and  drunk  either 
warm  or  cold  or  she  may  drink  water  in  which  dill  seeds  have  been  boiled. 
She  ought  to  work  more  than  usual  and  when  this  does  not  help  she 
should  be  given  medicine  that  will  make  the  blood  delicate  according  to 
the  complexion.  Oxymel  with  foreign  wine  taken  warm  if  the  complexion 
is  hot  or  Yspen  and  wild  marjoram  in  water  with  Oxymel  spl.  or  comp. 
in  cold  complexions.  One  should  examine  the  milk  until  it  comes  to 
its  right  consistency.  If,  however,  the  milk  is  too  fluid  the  nurse  should 
work  less;  drink  milk,  tender  meats  and  pastries  should  be  eaten  and 
she  should  sleep  as  much  as  needed.  A  good-tasting  sweet  bread  may  be 
eaten  and  Passauer  or  other  good  sweet  wine  may  be  taken.  She  may  eat 
bread  or  barley  gruel  or  millet  cooked  in  milk.  Every  morning  she  should 
drink  warm  goat  milk  or  cold  cow  milk  in  which  there  has  been  dissolved 
a  tablespoonful  of  sugar.  Then  she  should  fast  for  three  hours.  Or  one 
may  take  powdered  tragacanth  one  part  and  sugar  four  parts,  mixed 
with  each  other.  A  tablespoonful  of  this  powder  may  be  given  in  the 
morning  either  with  or  without  milk  until  the  milk  comes  to  the  right 
consistency.  If  the  milk  has  an  unusual  taste  it  should  be  milked  off 
before  it  is  given  to  the  child  and  one  should  give  her  tasty  foods.  If  the 
nurse  has  little  milk  this  may  arise  from  many  causes,  either  from  the 
heat  of  the  body  and  when  so  she  should  eat  no  hot  foods  but  milk, 
soups,  barley,  millet  or  rice  cooked  in  meat  broth,  or  lettuce  salad  may 
be  given  and  barley  water  in  which  lettuce  seeds  and  leaves  have  been 
boiled,  taken  as  a  drink.  The  powder  may  be  made  out  of  deumeten 
[mentha  crispa,  L.]  seeds,  dill  seeds,  fennel  seeds,  anise  seeds,  as  much 
of  one  as  the  other  and  as  much  sugar  as  all  the  seeds  together.  This 
should  be  powdered  and  mixed  together.  This  powder  should  be  used  by 
the  nurse  with  her  food,  pouring  wine  on  it  and  dipping  her  bread  in  it 
as  in  a  sauce.  Where  there  is  stoppage  of  the  milk  vessels  as  is  general  in 
cold  women,  she  should  take  fennel  seeds  or  dill  seeds  cooked  in  meat 
broth  and  drink  it  mixed  with  powdered  sugar.  When  little  milk  comes 
it  may  be  due  to  loss  of  weight  and  if  so  the  treatment  should  be  that 
recommended  for  delicate  and  too  fluid  milk  given  above.  The  breasts 
should  be  rubbed  with  a  cloth  of  fine  linen  especially  three  hours  after 
eating  or  when  fasting.  She  should  also  eat  the  udder  or  bag  of  goats  and 
sheep  [an  early  reference  to  glandular  therapy]  that  have  given  milk,  and 
drink  fresh  butter  in  wine  or  cooked  in  anise  and  ebsch  seed  and  lettuce 
in  barley  water.  This  with  the  food  or  used  as  a  drink  will  make  an  over- 
sufficiency  of  milk.  I  have  prolonged  what  I  had  in  my  writing  concern- 
ing these  things  but  let  no  one  bear  me  ill  will  as  it  concerns  the  welfare 
of  the  child  that  the  wet-nurse  be  careful  in  all  the  above  things. 

The  wet-nurse  shall  above  all  things  not  burden  the  stomach  with 
milk,  eggs,  fresh  meat,  beets,  green  salads,  barley,  peas,  cheese  and  the  like. 


82  PEDIATRICS  OF  THE  PAST 

Her  drink  should  not  be  strong  but  a  mild,  not  too  sour  wine.  Beer 
is  a  suitable  drink  but  it  ought  not  to  be  sour.  Fresh  water  in  summer 
time  is  especially  healthy  in  hot  nurses  and  a  cold  wet-nurse,  or  during 
winter  time,  one  may  allow  water  in  which  a  handful  of  dill  seeds  and  a 
half  a  handful  of  kimmel  seeds  have  been  cooked,  using  five  quartleins  of 
water  and  cooking  it  down  to  one  quartlein  or  one  can  boil  fennel  roots  in 
water.  The  results  noted  are  that  it  is  not  much  food  and  drink  that  makes 
a  good  wet-nurse  but  that  she  takes  her  food  regularly  and  drinks  after 
the  food  and  after  that  she  should  withdraw  until  such  food  has  been 
digested  and  not  to  eat  on  a  full  stomach  but  according  to  her  appetite. 
For  what  undesirable  habits  a  wet-nurse  has  will  be  transferred  to  the 
child. 

The  wet-nurse  should  avoid  strong,  salted,  or  spiced  food.  Salted 
meat,  garlic,  onions,  mustard,  and  krenn  or  anything  that  smells  should 
be  avoided.  For  spice  she  may  use  cinnamon,  muscat  flowers,  saffron, 
with  a  little  ginger.  Also  meat  and  fish,  milk  and  fish,  milk  and  wine 
drunk  together,  pork  and  sweet  wine  as  a  drink  should  be  avoided  as  such 
fluid  makes  the  nurse  and  the  child  inclined  to  chronic  diseases  as  scab 
or  other  eruptions.  Also  many  kinds  of  fish  make  bad  milk  but  fish 
without  scales  and  fat  fish  are  more  harmful  than  those  with  scales  and 
boiled  with  the  above  described  spices.  Preserved  crayfish  in  summer 
makes  good  milk. 

One  should  take  care  that  the  child  sucks  properly  and  one  should 
also  observe  whether  the  child  was  born  normal  or  not.  If  it  was  a  full 
term  child  neither  food  nor  drink  is  needed  at  least  in  the  first  three  days 
as  it  has  as  much  nourishment  as  it  can  digest  and  the  more  it  sleeps  the 
better  it  is  for  it.  One  should  take  care  to  get  another  wet-nurse  than  the 
mother  and  one  should  not  give  the  child  to  nurse  until  its  milk  is  out  of 
the  stomach  and  in  the  liver  above  one  hour  or  two  according  to  the  size 
and  appearance  of  the  child.  The  child  should  not  be  awakened  for  either 
food  or  drink  as  the  more  its  sleeps  the  better  it  is  for  it.  After  giving  it 
gruel  and  after  a  bath  it  should  not  be  nursed  until  a  full  hour  is  past 
but  when  a  child  is  poorly  nourished  and  thin  it  should  be  nursed  accord- 
ing to  its  needs,  but  never  more  should  be  given  than  it  can  digest. 
When  the  child  takes  too  much  it  has  a  pain  in  the  stomach  and  when  this 
happens  it  should  not  be  given  so  much.  It  should  be  bathed  with  an 
empty  stomach  and  the  abdomen  anointed  after  the  bath  with  rose  oil 
and  wormwood  and  should  be  made  to  go  comfortably  to  sleep  by  singing. 

One  should  also  know  about  the  gruel  that  is  given  to  it  after  it  has 
nursed;  when  the  milk  of  the  nurse  is  good  and  she  has  enough  the  child 
needs  less  gruel  especially  when  the  nursing  agrees  with  it;  when  the 
milk  is  not  good  or  when  the  wet-nurse  is  sick  or  has  little  milk  or  the 
baby  does  not  thrive  on  the  nursing  one  should  give  more  gruel.  One 


BARTHOLOMAEUS  METLINGER  83 

should  be  careful  not  to  burn  the  child  by  giving  it  gruel  that  is  too  hot 
as  it  is  an  old  wife's  opinion  that  if  the  gruel  will  not  burn  a  coarse  finger 
it  will  not  burn  the  tender  child. 

Further  it  should  be  known  that  children  are  to  be  nourished  on  gruel 
and  milk  until  they  cut  their  front  teeth.  One  may  then  give  somewhat 
stronger  food,  bread  soaked  in  milk  or  meat  soup  or  pea  soup  and  when 
they  become  older  one  can  give  lean,  well-cooked  meat  cut  very  fine  but 
in  small  quantity,  as  too  much  and  too  strong  meat  causes  worms  to 
grow.  The  normal  time  for  a  child  to  nurse  is  two  years  but  during  this 
time  it  can  be  allowed  other  things  to  drink  than  the  mother's  milk  and 
other  food,  such  as  gruels.  One  may  also  give  at  this  time  water  to 
drink  or  a  water  that  has  been  once  brought  to  a  boil  and  then  allowed  to 
cool,  or  at  times  a  well-watered  wine. 

Concerning  the  weaning  Metlinger  writes  in  the  following 
manner : 

It  may  be  remarked  that  if  the  nursing  agrees  with  the  child  it  can 
be  allowed  to  nurse  but  if  it  is  not  gaining  in  weight  or  if  the  wet  nurse 
becomes  pregnant  or  if  one  cannot  get  another  wet-nurse  it  may  be 
necessary  to  wean  the  child,  but  if  the  child  is  weaned  it  should  be  done 
in  a  proper  manner  so  that  each  day  the  nursing  is  discontinued  and 
water  given  to  drink  which  has  been  cooked  once  and  allowed  to  cool,  or 
sugar  water  made  with  one  ounce  of  sugar  and  a  measure  of  water  and 
boiled  as  long  as  it  will  take  to  cook  a  hard  egg.  A  bread  rind  may  be 
cooked  in  it  in  order  that  the  child  may  be  strengthened.  But  if  the  child 
is  young,  that  is  to  say  under  a  year,  and  it  must  be  weaned,  one  gives  it 
goats'  milk  to  drink  out  of  a  cornucopia  or  a  little  jug.  The  milk  is 
boiled  with  one-quarter  water  and  an  electuary  may  be  made  out  of 
white  bread  and  sugar  as  Avicenna  tells,  rub  together  one  part  of  fine 
bread  and  one-quarter  part  sugar  and  mix  it  as  an  apothecary  would. 
When  they  search  for  the  breast  crying,  the  nipples  may  be  painted  with 
myrrh  wine  or  wormwood  juice  and  the  child  allowed  to  nurse.  It  should 
also  be  noted  that  when  children  are  over  three  years  of  age  it  is  their 
nature  to  eat  much  and  one  should  feed  them  well,  a  little  at  a  time  but 
often.  As  Hippocrates  says,  children  shall  not  be  disturbed  at  their  meals 
on  account  of  their  growth,  and  food  which  disturbs  their  digestion, 
that  is,  too  much  dry  bread  and  fish,  and  also  wine  to  drink,  should  not 
be  allowed  but  the  child  placed  on  milk  alone,  even  though,  in  this  time, 
there  is  no  disease.  As  Galen  says,  a  bad  ordering  of  life  in  the  young 
shows  itself  later  on. 

In  general  it  should  be  understood  that  the  diet  in  children  should  be 
moist  both  as  to  food  and  drink,  as  Hippocrates  says,  that  they  may 
grow  in  length,  breadth  and  thickness  and  this  cannot  take  place  without 


84  PEDIATRICS  OF  THE  PAST 

moisture.  And  also  shall  the  child  have  regular  exercise  so  that  its  natural 
warmth  is  increased  and  its  limbs  made  strong.  The  exercise  should  not 
be  too  much  lest  the  food  be  not  absorbed. 

And  here  ends  another  chapter. 

The  third  chapter  treats  the  diseases  which,  in  the  author's 
opinion,  most  frequently  affect  children.  He  describes  twenty-five 
different  diseases  from  head  to  foot,  giving  for  the  most  their 
definitions,  their  causes  and  their  treatments.  Metlinger  writes 
as  follows: 

If  the  child  is  sick  it  should  not  then  be  nursed,  the  wet-nurse  should 
stop  just  as  if  she  had  the  disease  herself.  Where  there  is  little  milk 
present,  it  should  be  changed  as  described  above  and  when  the  child 
will  not  take  what  is  advised  then  the  wet-nurse  should  take  it  herself. 
If  the  wet-nurse  is  well  developed  and  rosy  one  should  bleed  her  but  if 
she  is  pale  she  should  be  purged.  That  is  the  first  and  the  most  important 
of  all  diseases  of  children.  It  should  be  understood  that  some  diseases 
in  children  come  before  their  teeth  are  cut  and  some  while  they  are  being 
cut  and  some  after  they  are  cut  and  Hippocrates  differentiates  this  in  his 
aphorisms,  but  such  order  and  description  I  will  not  follow  but  con- 
sider the  most  common  diseases  which  affect  the  child  from  the  head 
downward. 

i.  Of  scurf:  Scurf  is  a  sort  of  roughness  that  affects  children  on  the 
head  and  face  and  numerous  places.  It  is  of  two  kinds.  One  is  accom- 
panied with  itching  and  biting  and  the  other  with  itching  and  biting 
and  scales.  A  cause  is  overflowing  of  the  blood  and  a  moisture  from  the 
inside  of  the  head  outwards.  The  sign  of  the  disease  coming  on  is  the 
child  is  unwell,  whines  and  cries.  It  is  recommended  in  this  disease  that 
the  wet-nurse  shall  take  little  food  at  night  and  not  take  any  food  that  is 
irritating  or  smells  strongly.  The  children  should  have  their  hair  cut  and 
the  irritated  place  covered  with  a  malt  poultice  to  draw  out  the  bad 
moisture  and  when  the  scurf  is  off,  one  should  use  a  white  and  yellow 
salve  of  each  a  half  ounce,  the  whites  of  two  eggs  and  one  ounce  of  ash 
lye.  If  the  scurf  is  accompanied  with  itching  and  scaling  and  horny  like 
crusts  the  child's  head  should  be  washed  in  the  morning  with  two  parts 
steaming  water  and  one  part  maserva  water  and  then  anoint  it  with  white 
and  cold  salve  of  which  a  half  ounce,  quicksilver  and  sulphur  and  vinegar, 
of  each  one  quintel. 

2.  Of  unnaturally  large  size  of  the  head:  Avicenna  calls  this  disease  a 
watery  swelling  of  the  head  which  affects  children  at  times  while  in  the 
mother's  body,  however,  seldom.  It  begins  generally  after  the  seventh 
day  and,  on  account  of  the  great  changes  in  the  appearance,  these 
children  are  called  changed  children.  I  have  seen  a  child  whose  head  was 


BARTHOLOMAEUS  METLINGER  85 

so  large  that  it  could  not  raise  the  body  and  it  increased  daily  in  size 
until  the  child  died.  The  cause  is  twofold  as  Gentilis  tells.  First  is  the 
superabundance  of  the  moisture  of  the  head;  the  other  is  the  thickness 
of  the  covering  of  the  brain;  and  the  third  is  the  vapor  which  changes  to 
water  in  the  head. 

The  reason  why  children  develop  such  a  head  only  seven  days  after 
the  birth  is  that  all  hereditary  diseases  are  postponed  until  the  age  in 
which  conditions  for  this  are  suitable  as  one  notes  in  smallpox  and  in 
eruptions  and  so  is  it  also  in  this  disease.  As  long  as  the  fetus  is  in  the 
mother's  body  the  heat  of  the  mother  and  the  subtility  of  the  covering  of 
the  brain  destroy  the  vapor,  which  is  not  the  case  after  the  child  is  born. 

It  is  advised  that  the  wet-nurse  be  cleaned  with  medicine  and  be 
forbidden  all  irritating  food  and  things  which  inflate  the  stomach. 
Sage  in  a  little  sack  should  be  put  in  the  bath  and  when  the  child  is  being 
bathed  it  should  be  placed  on  the  head.  It  should  be  bathed  fasting  and 
after  the  bath  should  be  anointed  with  bitter  almond  oil  and  dill  oil 
should  be  put  up  the  nostril  with  a  little  feather  and  then  the  child  should 
be  allowed  to  sleep  before  it  is  fed.  The  wet-nurse  should  be  given  white 
lily  water  or  marjoram  water  and  the  child  should  also  be  given  a  little  to 
drink.  The  head  should  be  kept  warm.  When  these  things  do  not  help,  one 
should  make  a  plaster  out  of  serapion,  sarcocol,  gum,  almonds  and  white 
incense  and  apply  it  like  a  cap.  If  this  does  not  help  one  should  make  a 
broth  of  garlic  corns  packed  in  hot  ashes  and  mixed  until  it  is  a  white 
mousse  and  mix  it  with  a  half  ounce  of  incense  and  lay  it  on  the  child  for 
some  days  so  that  the  head  may  take  its  natural  form.  After  that  one 
should  make  a  nasal  suppository  out  of  wolf's  gall  and  brains  with 
myrrh  and  for  two  months  this  should  be  shoved  in  the  nose  every  eight 
days  while  the  child  is  fasting  and  let  it  stay  for  a  half  hour. 

The  increase  in  the  size  of  the  head  may  also  come  from  large  hemor- 
rhages and  vapors  which  blow  up  the  head.  To  differentiate  the  moisture 
from  the  hemorrhage,  when  one  grasps  the  watery  tumor  it  pits,  which 
does  not  happen  if  the  swelling  is  blood.  If  the  swelling  is  of  blood,  take 
wild  marjoram,  with  castor  and  foreign  kimmel  mixed  together  and 
powdered  and  of  this  take  six  barley  grains  in  weight  in  marjoram  water 
or  rose  honey  and  anoint  the  child  in  the  morning  after  the  bath,  or  one 
applies  some  theriac  using  one  one  day  and  the  other  the  next.  Of 
smallness  or  largeness  of  the  head  that  is  present  from  birth  there  is  no 
remedy. 

3.  Of  a  disease  called  Durstig  [meningitis] :  Such  a  disease  comes  from 
a  hot  abscess  covering  the  brain.  The  signs  of  it  are  great  heat  and  pain 
in  the  head,  dryness  of  the  tongue;  the  child's  face  becomes  pale,  and 
the  eyes  are  turned  out.  In  this  disease  it  is  advised  continuous  moist 
applications  of  water  in  which  there  have  been  boiled  pumpkin  rinds 


86  PEDIATRICS  OF  THE  PAST 

poppy  seeds,  lettuce  and  night  shade  and  roses  and  one  adds  to  the 
water  a  little  vinegar.  With  this  a  cloth  is  moistened  and  laid  on  the  head 
and  moistened  frequently  or  one  may  use  rose  oil,  vinegar  and  the  white 
of  an  egg  mixed  together  and  applied  to  the  head.  The  child  should  be 
given  senna  leaf  water  to  drink  or  almond  milk  and  rose  sugar  or  sugar. 
Of  the  senna  leaves  one  may  give  it  often  and  above  all  protect  the  child 
from  heat. 

4.  Of  waking:  When  children  continuously  remain  awake  it  is 
necessary  to  consider  this,  as  much  sleeplessness  after  birth  is  the  begin- 
ning of  many  different  diseases  which  during  sleep  would  otherwise 
disappear.  The  cause  is  heavy  vapors  that  arise  in  the  head  from  strong 
milk.  It  is  advised  that  the  wet-nurse  on  going  to  sleep  drink  milk, 
part  almonds  and  another  part  of  white  poppy  seeds  and  to  behave 
herself  properly.  As  to  the  child  one  should  anoint  the  temples  with  the 
following  salve:  populem  salve,  one  ounce,  white  poppy  seeds  and  hen- 
bane seeds,  of  each  ten  barley  corns  in  weight,  and  bind  a  little  bandage 
over  this.  In  the  evening  before  using  the  salve  one  should  apply  a  little 
violet  oil  in  the  nostrils  or  one  can  mix  the  milk  of  a  woman  that  has 
suckled  a  daughter  with  the  white  of  an  egg  and  lettuce  juice  and  dip  a 
little  lint  made  from  soft  cloth  in  this  and  bind  it  over  the  temples  during 
the  night  to  cause  sleep. 

5.  Of  convulsions:  Convulsions  is  in  children  a  falling  sickness 
which  affects  them  in  two  manners :  either  directly  after  birth  or  some 
time  after.  The  cause  of  the  first  may  be  immoral  conduct  in  the  life  of 
the  mother  while  she  carries  the  child  so  that  she  leaves  her  room  for 
desires,  either  for  good  or  bad,  or  imbecility  in  the  head  of  the  fetus  which 
originates  under  the  influence  of  the  stars.  If  the  child  has  convulsions 
after  birth  it  is  due  to  bad  milk  of  the  wet-nurse  or  because  the  child  is 
nursed  improperly;  one  time  too  little  at  another  too  much,  or  that  it  is 
given  suck  continuously  so  that  it  cannot  digest;  also  fright,  fear  and  lack 
of  care.  It  should  be  known  that  when  convulsions  affect  a  child  soon 
after  birth  it  generally  dies.  My  advice  is  to  protect  the  children  with  the 
help  of  God.  Children  may  die  from  this  but  one  should  protect  those 
that  come  later.  When  the  child  is  born  it  should  be  given  a  tablespoonful 
of  the  following  electuary  before  any  food  is  given :  sugar  bolermo  4  loth 
(2  oz.)  and  freshly  pressed  almond  oil  cooked  over  a  slow  fire  to  a  thin 
mousse.  It  should  also  be  given  between  feedings,  a  half  hour  before  and 
after.  The  child  should  also  be  kept  quiet  and  in  the  dark  and  one  gives 
it  to  suck  intermittently  and  so  it  is  spared. 

Signs  of  convulsions  coming  on  after  birth  are  much  crying,  much 
waking,  fear  and  crying  out  in  sleep  and  difficult  breathing. 

It  is  advised  that  the  nursing  woman  behave  herself,  avoid  sin, 
avoid  eating  apples,  be  clean  and  not  give  the  child  too  much  at  a  nurs- 


BARTHOLOMAEUS  METLINGER  87 

ing  but  little  and  often ;  it  should  still  be  kept  quiet  and  in  the  dark.  On 
the  front  of  the  head  where  the  skull  is  open  it  should  be  anointed  with  a 
salve  made  out  of  chamomile  oil  (one-half  part)  and  mastich  oil  (one- 
half  part)  and  on  this,  every  morning,  powder  with  mastich  (3  quintel) 
and  varnish  (4  quintel)  until  it  falls  off  of  its  own  accord  in  six  weeks. 
The  nostrils  should  be  painted  daily  with  chamomile  oil  and  around  the 
neck  there  should  be  hung  a  peony  root,  an  emerald  or  some  other  pre- 
cious stone  that  is  green  and  which  has  the  property  of  warding  off  the 
convulsion.  Internally  it  is  good  to  give  a  little  theriac  or  an  electuary 
of  diaplus  c.  musco  or  diamusci  dulcis  made  into  a  soft  electuary  every 
day  with  rose  syrup,  until  one  can  hope  that  the  child  is  safe.  If  one 
wishes  to  bathe  it,  chamomile  should  be  cooked  in  the  bath  water  and 
after  the  bath  anoint  the  abdomen  with  mastich  and  oil  of  sweet  almonds. 
It  should  also  be  known  that  such  disease  as  first  comes  after  three 
years  of  age  is  very  severe,  yet  they  change  and  leave  the  child  so  that 
nature  grows  and  the  breasts  form  in  females  and  the  beard  in  males. 
When  such  disease  begins  after  twenty-five  years  it  generally  lasts  a 
lifetime.  Hippocrates  also  states  this.  And  so  it  is  with  many  diseases 
which  change  with  increasing  years. 

6.  Of  paralysis  which  affects  children:  When  children  are  large  and 
the  teeth  are  cut  with  difficulty,  they  are  paralyzed  at  times  with  great 
pain.  Such  paralysis  disturbs  the  digestion,  whereby  much  superfluity 
originates  in  them,  which  paralyzes  the  white  vessels  (the  nerves).  They 
easily  get  an  excess  of  fluid  from  their  weakness  and  this  overcomes  them. 
It  is  advised  to  forbid  the  nursing  women  all  heavy  and  fat  food  which  is 
hard  to  digest  and  to  use  a  light  diet  which  dries.  The  child  should  be 
bathed  fasting  and  chamomile  boiled  in  the  water  and  after  the  bath  the 
child  should  be  anointed  from  the  neck  down  to  the  hips  with  a  salve  of 
white  lilies  and  beaver's  testes  with  wax  to  make  a  soft  salve.  The  child 
should  also  be  given  every  morning  15-30  barley  corns  weight  of  the 
following  electuary:  deumeten  [mint],  rose  sugar,  cloves,  cinnamon, 
mastich,  valerian  root,  cinnamon  (of  each  1  quintel),  musk  (15  barley 
grains)  powdered  together  and  softened  in  2  loth  (1  oz.)  oil  of  bitter 
almonds,  then  dried  and  mixed  with  as  much  honey  as  may  be  needed. 
Also  a  plaster  may  be  made  of  olive  oil  (2  loth),  euphorbia  (1  quintel) 
and  rub  it  upon  thin  leather  and  bind  it  on  the  back  after  the  salve  is 
applied.  If  the  paralysis  follows  fever  and  they  are  badly  wasted  they 
should  be  bathed  every  day  in  water  in  which  poplar  and  violets  have 
been  boiled  and  after  the  bath  the  buttocks  should  be  anointed  with  a 
salve  of  violet  oil  and  white  wax  and  also  the  front  part  of  the  head  where 
it  remains  open  the  longest. 

7.  Of  the  moisture  that  runs  from  children's  ears:  Running  ears 
come  from  too  great  moisture  of  the  head.  It  is  recommended:  one  shall 


88  PEDIATRICS  OF  THE  PAST 

stick  cotton  in  the  ear  to  absorb  the  moisture,  when  you  wish  to  dry  it 
up  more  rub  alum  with  a  little  wine,  dip  the  cotton  in  it  and  put  in  the 
ear.  When  the  discharge  from  the  ears  comes  from  ulcers,  drop  i  or  3 
drops  of  honey  water  in  the  ear  and  incline  the  child  so  it  runs  out. 
Do  this  two  or  three  times  until  the  honey  water  runs  out  clear.  Then 
take  myrrh  and  pulverized  acorns  in  wine  and  honey  water  and  put  two 
drops  in  the  ear  and  this  medicine  should  be  warm  when  put  in  the  ear, 
but  in  the  eye  it  is  used  cold. 

It  should  be  known  that  running  ears  are  not  always  to  be  stopped, 
as  when  the  flow  ceases  the  child  may  hear  badly,  but  so  its  nature 
according  to  its  nature  grows,  so  it  generally  leaves  the  child  of  itself,  as 
is  described  above  in  convulsions. 

8.  Of  swelling,  pain  and  smarting  of  the  eyes:  Swelling,  pain  and 
smarting  comes  from  a  running  of  the  head.  Sometimes  the  flow  is  hot 
and  then  the  white  of  the  eye  is  red.  When  the  flow  is  cold  the  white  is 
not  red.  It  is  recommended:  When  it  comes  from  heat,  use  a  little 
cloth  wet  with  rose  water,  bean  flower  water  and  peony  water,  equal 
parts  and  lay  it  on  the  child's  eyes.  Also  take  a  little  camphor  rubbed  up 
in  woman's  milk  and  towards  evening  drop  a  little  in  the  nostrils.  Put  the 
child  in  the  dark  and  let  it  sleep  a  lot.  When  the  eyes  do  not  run  any  more 
place  the  child  for  half  an  hour  in  a  water  bath.  When  the  swelling  is 
from  cold,  place  a  cloth  moistened  with  fennel  water  or  peony  water  on 
the  eye.  Rub  up  a  little  amber  with  woman's  milk  and  put  a  drop  of  this 
in  the  nostrils  towards  evening. 

9.  Of  squint:  When  a  child  squints  outdoors  or  otherwise  set  some- 
thing before  him  he  likes  to  see.  Also  no  one  should  approach  him  on  the 
squinting  side.  And  frequently  let  him  look  in  a  mirror  set  in  a  cowl 
directed  to  the  nonsquinting  side  so  that  it  cannot  see  anything  except 
in  the  mirror  until  it  goes  to  sleep.  If  one  does  this  often  it  will  leave 
him.  Where  there  is  other  disease  of  the  eyes  it  is  recommended  to  use 
weak  medicines  as  in  older  people. 

10.  On  cutting  the  teeth:  In  many  children  the  teeth  come  easily 
and  with  little  pain,  these  generally  fall  out.  If  the  teeth  come  with 
much  pain  they  are  that  much  stronger.  Teeth  are  cut  easiest  in  the 
spring,  less  so  in  summer  and  hardest  in  winter.  As  the  teeth  begin  to 
appear  various  evils  befall  children  such  as  swelling  of  the  jaws  and 
neck  and  other  diseases  are  apt  to  come  on.  When  the  jaws  swell  rub  them 
with  honey  and  salt,  this  takes  away  the  pain  and  gives  strength  to  the 
jaw.  As  the  teeth  come  through  let  the  child  chew  on  violet  or  moist 
licorice  root.  When  the  points  of  the  teeth  come  then  they  desire  to  chew 
and  bite  hard,  then  one  must  keep  them  from  chewing  too  hard  things 
and  one  should  rub  the  jaw  with  hare's  brains  and  chicken  fat  or  with 
bitches'  milk,  whose  properties  are  to  make  more  easy  the  cutting  of  the 


BARTHOLOMAEUS  METLINGER  89 

teeth  and  one  should  let  them  chew  on  cooked  rosin  or  violet  root  or  on 
licorice  root. 

n.  Of  swelling  of  the  jaw  bone  or  about  the  neck:  One  should 
know  that  such  swelling  in  children  comes  at  a  time  when  the  teeth  are 
cut  or  shortly  after,  they  come  from  too  much  drinking,  which  causes 
running  which  makes  the  swelling. 

It  is  recommended:  The  child  should  be  kept  warm  about  the 
swelling,  should  be  rubbed  with  a  salve  made  out  of  violet  oil,  rose  oil, 
and  yellow  wax  melted  over  a  slow  fire  and  bound  on  with  warm  cloths. 
If  this  does  not  help  take  bran  and  laurel  oil,  mix  them  together  and  lay 
it  on  the  child  over  the  swelling  where  it  can  dissipate  it  or  ulcerate  it 
according  to  inclination.  And  so  one  will  seek  further  advice  according 
to  need. 

12.  About  the  blisters  that  originate  in  children's  mouths:  The 
blisters  in  the  mouths  of  children  come  from  diseased  and  strong  milk  of 
the  wet-nurse  and  in  many  ways.  Some  are  red  or  yellowish  and  but 
little  saliva  flows  from  them;  some,  however,  are  white  and  no  saliva 
flows  from  them;  some  are  black  and  these  are  dangerous. 

Recommendation:  One  should  forbid  the  wet-nurse  all  hot  and  salty 
food  and  drink.  When,  however,  the  blisters  are  reddish  or  yellowish  one 
should  paint  the  child  with  starch  rubbed  with  rose  water  to  a  thin  paste; 
also,  pomegranate  juice  may  be  held  in  the  mouth  and  mulberry  pulp 
rubbed  with  Weggraswasser  [aqua  plantaginus]  may  be  given.  If  the 
blisters  are  black  one  should  quickly  give  the  child  lead  water  and  night- 
shade water  and  let  him  hold  it  in  the  mouth.  Lettuce  juice  held  in  the 
mouth  is  also  useful.  When  the  blisters  are  white  and  much  saliva  flows 
one  should  wash  the  mouth  frequently  with  red  wine  or  paint  the  child's 
mouth  frequently  with  myrrh  (1  quintel),  sugar  (}i  quintel),  saffron 
(5  barley  corn  weight)  mixed  with  rose  honey. 

13.  Of  cough  and  difficult  breathing:  Cough  comes  to  children  in 
that  the  tongue  is  not  sufficiently  in  place  to  protect  the  air  passages  from 
cold. 

Recommendations:  One  should  give  the  child  almond  milk  to  drink, 
with  fennel  water  and  seethed  with  licorice.  When  the  cough  is  dry  one 
should  give  an  electuary  of  soft  quince  slime,  spun  sugar  and  sweet  oil 
of  almonds;  spun  sugar  alone  is  also  good.  If  the  cough  is  with  heat 
[fever]  one  gives  an  electuary  of  tragacanth  and  poppy  seeds  (of  each  1 
quintel),  turmeric  seeds  (2  quintel)  with  as  much  violet  syrup  as  is 
needed.  And  a  noble  remedy  for  the  child's  cough  is:  Italian  grapes 
roasted  dry  in  an  iron  pan  and  then  rubbed  up  with  sufficient  spun  sugar 
and  violet  oil  as  will  make  an  electuary,  of  this  give  the  child  as  much  as 
the  size  of  a  hazelnut.  Borage  sugar  and  violet  sugar  are  also  useful  for 
coughs.  When,  however,  the  cough  comes  from  overmuch  moisture  in  the 


5K>  PEDIATRICS  OF  THE  PAST 

chest  one  mixes  tragacanth  and  galbanum  (of  each  25  barley  grains) 
together  and  gives  it  to  the  fasting  child  either  mixed  in  milk  or  in  egg. 
If  the  child  has  difficulty  in  breathing  give  it  frequently  of  powdered  lin- 
seed mixed  with  honey. 

14.  Of  indigestion  and  hiccup:  Indigestion  comes  in  children  from 
the  surplus  milk  which  they  cannot  digest  and  especially  when  it  is  bad 
and  the  child  has  a  moist  and  weak  little  stomach. 

Advice:  The  nursing  woman  shall  conduct  herself  properly  and 
shall  nurse  the  child  properly,  so  that  it  may  digest.  Also  it  should  be 
noted  whether  the  undigested  [vomitus]  is  sour  or  yellow  or  bitter. 
If  it  is  weakly  sour  the  child  should  be  given  a  little  beaten  cloves  with 
minia  of  quinces  or  give  the  child  ten  barley  grains  weight  of  powdered 
mint  in  pomegranate  syrup  or  one-half  hour  after  eating  a  hazelnut  size 
of  the  following  electuary:  aloes  and  mastich  (of  each  one-half  quintel); 
acorns  (10  barley  grains)  and  as  much  syrup  and  rose  water  as  is  needed. 
Over  the  stomach  and  region  of  the  heart  a  plaster  of:  mastich,  aloe 
juice,  acorns,  white  incense,  and  well-fomented  bread  mixed  with  the 
necessary  rose  oil.  If,  however,  the  undigested  is  bitter  and  yellow  one 
gives  the  child  a  "rob  von  agrest  (Omphacium)"  or  quinces  or  half  of  a 
little  roll;  the  so-called  Tro-aschen  rubbed  in  rose  syrup:  red  roses,  burnt 
ivory  (of  each  one-half  loth),  oak  gall  (1  quintel),  bucingo  seeds  (one- 
half  quintel),  yellow  amber  (15  barley  grains);  what  can  be  powdered 
should  be  powdered  and  with  rose  water  a  roll  is  made  of  each  half 
quintel.  One  such  roll  is  rubbed  up  with  oil  and  rose  water  to  a  white 
plaster  and  laid  over  the  stomach.  When  the  milk  comes  out  after  the 
child  has  nursed  mix  rose  syrup  and  Agrests  syrup  and  smear  it  on  the 
child  a  little  while  before  nursing.  If  the  child  hiccups  mix  the  above- 
named  syrup  with  the  digesting  powder  (20  barley  grains)  and  give  to 
the  child  to  suck  on  a  finger  [smeared  with  it]. 

15.  Of  jaundice:  Jaundice  comes  from  the  coarse  thick  milk  of  the 
nursing  woman,  through  which  the  passages  of  the  liver  and  bile  become 
stopped  up. 

Advice:  The  nursing  woman  should  be  managed  as  described  above 
for  thick  milk.  Also  she  should  be  bled  from  a  vessel  in  her  hand  or  arm. 
The  child  should  have  in  its  bath  a  little  bag  of  strawberry  leaves  and 
roots.  After  the  bath  give  him  one  or  a  half  quintlein  Triasandaly  rubbed 
to  a  white  mousse  in  thistle  syrup.  On  this  let  it  fast  an  hour  and  a  half. 
If  it  is  very  thirsty  give  it  or  the  wet-nurse  thistle  or  strawberry  water 
to  drink.  The  nursing  woman  should  avoid  pastry,  fish,  cheese,  and  the 
child  should  not  be  carried  into  the  air. 

16.  Dysentery:  Dysentery  generally  comes  while  teething,  from 
bad  digestion,  from  bad  milk,  from  cold,  or  from  superabundant 
fluid  and  bad  moistness. 


BARTHOLOMAEUS  METLINGER  91 

It  is  advised:  If  the  dysentery  is  in  a  nursing  infant,  the  nursing 
woman  should  break  her  fast  every  morning  by  drinking  skimmed  goat's 
milk  that  has  been  warmed  with  hot  stones;  after  this  she  should  fast 
three  hours.  Her  diet  should  be  of  cooked  things  and  other  foods  that 
dry.  Her  drink  should  be  of  gestechlotes  water  [water  in  which  red  hot 
steel  has  been  plunged]  if  the  dysentery  is  accompanied  with  heat, 
and  a  red  wine  with  such  water  if  the  dysentery  is  without  heat.  One 
should  give  the  child  a  sugar  rosat,  softened  with  rose  or  pomegranate 
syrup,  mixed  with  i}i  loth  digestive  powder.  In  the  bath  one  should  boil 
roses,  chamomile  and  deumeten  in  a  little  bag;  also  make  a  little  bag  of 
roses  1  part,  deumeten  J^  part,  and  alipta  muscata  1  quintel,  and  bind 
this  on  the  little  stomach  to  dry  it.  If  the  child  is  not  nursing  give  it 
skimmed  goat's  milk,  also  almond  milk  diluted  with  gestechlotes  water.  It 
should  also  be  known  that  dysentery  should  not  be  carelessly  regarded 
lest  it  get  the  upper  hand  and  weaken  the  child.  If  that  is  the  case  one 
should  take  a  measure  [Maass]  of  gestechlotes  water  and  put  in  it  J£  loth 
of  burned  ivory,  or  one  should  bake  a  little  canape  of  1  egg  yolk  and  3^ 
muscat  nut  on  a  hot  hearth,  boil  it  in  a  measure  of  gestechlotes  water  and 
give  it  to  the  child  to  drink;  otherwise  use  the  medicines  given  above. 

17.  Of  hardness  of  the  abdomen  and  the  stools:  If  the  nursing  child 
is  hard  in  its  body  [constipated]  the  nursing  woman  should  be  given  a 
laxative,  especially  if  she  too  is  constipated.  From  below  one  should 
introduce  a  suppository  [Zapflein]  of  hard  salted  lard  or  give  it  raw 
butter.  And  when  the  children  are  12  weeks  old  and  are  still  constipated 
and  become  pale  and  yellow  from  it,  one  may  without  fear  give  them 
muscat  rubbed  in  milk  and  a  mousse  out  of  it,  as  Avicenna  tells.  Also  ox 
gall  and  honey  bound  over  the  navel  loosens  the  child.  Also  one  may 
without  hesitation  give  it  a  suppository  from  the  apothecary. 

18.  Of  prolapse  of  the  large  bowel:  The  large  bowel  comes  out  of  the 
body  of  children  either  from  hard  stools  or  because  of  a  tendency  to  it. 
If  the  bowel  is  already  out  the  child  should  be  bathed  in  water  in  which 
poplar  [leaves]  have  been  boiled  and  after  the  bath  lay  on  it  a  little  cloth 
wet  with  violet  oil.  As  soon  as  the  bowel  is  inside,  the  child  should  be 
bathed  in  water  in  which  acorns,  whortleberry  leaves  and  pomegranate 
hulls  have  been  boiled,  so  that  the  large  bowel  will  be  retained.  If  there  is 
a  tendency  for  the  bowel  to  come  out  again,  one  should  keep  the  child 
continuously  warm  and  hold  warm  linen  cloths  on  its  anus. 

19.  Of  worms  and  pain  in  the  abdomen:  Pain  in  the  abdomen  and 
complaint  about  the  stomach  comes  at  times  from  gripes  or  from  worms. 
A  warm  cloth  placed  over  the  little  stomach  will  ease  the  pain.  If,  how- 
ever, the  pain  comes  from  worms,  the  child  chews  in  its  sleep  and  when 
it  awakens  scratches  the  nostrils.  By  day  they  are  thirsty  and  the  tongue 
is  dry,  by  night  the  worms  may  come  out. 


92  PEDIATRICS  OF  THE  PAST 

It  is  advised:  First  one  tries  external  remedies  [pulverized]  Welch 
nuts  mixed  with  ox  gall  laid  on  the  navel  for  three  or  four  hours  in  the 
morning,  or  lupine  and  laurel  mixed  with  the  gall,  and  give  the  child  a 
warm  drink  of  water  in  which  sebesten  [a  plum-like  fruit,  cordia  mixa,  L.] 
have  been  boiled,  or  let  it  eat  about  six  almond  kernels.  Also  internally 
the  child  may  be  given  worm  seeds  or  worm  powder  and  if  that  does  not 
help,  give  the  child  three  mornings  after  another  warm  milk  to  drink 
and  on  the  fourth  morning  J^  quintlein  worm  seeds  or  worm  powder  in 
the  milk  and  let  it  fast  three  hours.  If  this  does  not  help,  seek  further 
advice  as  children  sometimes  die  from  this  and  so  the  advice  is  not  to  be 
despised. 

20.  Of  rupture  at  the  navel  or  scrotum:  Little  ruptures  come  on  in 
children  from  much  crying,  yelling  or  hard  coughing. 

It  is  advised:  Take  lupine  and  linen  tow  and  burn  them  in  a  closed 
crucible  in  the  embers.  Out  of  the  powder  make  a  plaster  with  wax  and 
turpentine  and  lay  it  on  as  may  be  necessary  with  a  little  bellyband.  If 
necessary  renew  the  plaster,  or  take  ameos  [fructus  majoris],  pulverize  it, 
cover  it  with  the  white  of  an  egg  on  a  hempen  bellyband  and  when  it  falls 
off,  renew  it  and  bind  it  on  the  other  way.  Also  there  can  be  had  at  the 
apothecary's  plasters  for  hernia  which  are  good  and  proved. 

21.  Of  urine  stones:  Urine  stones  come  in  children  because  the 
mother  eats  much  cheese  or,  according  to  others,  many  brown  berries, 
whortleberries  or  elderberries.  The  signs  of  urine  stones  are  that  the  child 
urinates  frequently  and  little  and  may  desire  to  pass  urine  without  being 
able  to  do  so.  Or  perhaps  there  may  be  erections  of  the  penis  or  the  child 
catches  hold  of  the  genitals  and  scratches. 

It  is  advised:  One  should  wash  the  child  seven  consecutive  mornings 
in  a  bath  and  after  the  bath  anoint  the  scrotum  with  old  olive  oil  and  then 
one  should  give  him  every  morning  a  drink  made  of  six  green  walnuts 
with  a  handful  of  leeks  or  pforzen  [Allium  porrum,  L.]  bruised  and  the 
juice  extracted,  H  loth  of  the  juice  and  H  loth  thistle  syrup  mixed  with 
strawberry  water,  give  it  to  the  child  and  then  let  it  fast  two  or  three 
hours.  If  this  does  not  help,  it  is  advised  not  to  try  medicines  further  but 
one  should  let  it  [the  stone]  be  cut  by  masters  as  undertake  such  things. 

22.  Of  scab,  furuncles  and  fistula :  Scurf  comes  generally  after  wean- 
ing when  the  infant  is  not  nourished  on  children's  food  but  is  given  too 
much  fish,  meat  and  wine  and  milk. 

Advice:  Scurf  should  not  be  driven  in  but  pulled  out;  do  this  and 
cover  well  and  steam  over  hot  water.  Internally  give  the  child  fig  water 
to  drink  and  figs  to  eat:  also  wegwarten,  fumitory,  vermouth,  or  fennel 
water  to  drink  is  healthy.  When  the  scabs  are  all  out  the  child  should  be 
washed  every  second  day  in  a  bath  in  which  rose  leaves  [Rosenzelt]  have 
been  boiled.  After  the  bath  anoint  the  fissures  and  cracks  with  violet  oil, 


BARTHOLOMAEUS  METLINGER  93 

creams  or  litharge  salve.  Sweat  baths  are  dangerous.  If  the  scurf  itches 
bathe  the  child  daily  in  a  bath  in  which  violets  or  poplar  leaves  have 
been  boiled  and  after  the  bath  anoint  the  back  with  violet  oil  and  white 
wax.  If  children  have  furuncles  one  should  not  open  them  but  apply 
Diachylon  spl.  from  the  apothecary's.  If  children  are  chafed  from  urine 
or  sweat,  dry  them  after  the  bath  with  lint  scraped  off  a  cloth.  If,  how- 
ever, ulcers  appear  they  should  be  healed  with  litharge  salve  and  white 
salve  equal  parts  and  covered  with  lint. 

23.  Of  fevers:  If  children  have  more  natural  heat  than  that  to  which 
they  are  accustomed,  or  if  they  are  at  one  time  cold  and  another  hot, 
they  have  fever. 

Advice:  If  nursing  children  have  fever  the  nursing  woman  should 
avoid  wine,  fish,  meat,  and  eggs.  She  should  drink  barley  water  and  if  the 
child  is  restless  the  nursing  woman  should  be  bled  or  purged  according 
to  need.  Afterwards  take  one  morning  theriac  and  then  fast  six  hours  and 
the  child  should  be  given  syrup  of  verjuice  [the  juice  of  unripe  fruit, 
particularly  grapes]  for  the  thirst  and  a  sugar  rosat  softened  with  rose 
syrup  to  strengthen  [the  child].  Likewise,  do  with  children  who  are  not 
nursing.  When  this  does  not  help  one  should  anoint  the  back  and  chest 
every  morning  and  evening  with  a  salve  of  oil  of  yellow  senna  leaves  and 
blooms  (3  loth),  sour  sorrel  leaves  (1  quintel),  sandalwood  (15  barley 
corns),  red  coral  (15  barley  corns),  bone  from  the  deer's  heart  (8  barley 
corns),  camphor  (1  barley  corn).  As  much  as  can  be  powdered  is  to  be 
powdered  and  a  salve  is  to  be  made  of  wax  and  rose  water,  according  to 
the  apothecary's  art.  Such  salve  is  as  effective  against  fever  as  poison  is 
against  the  heart  and  I  have  noted  it. 

24.  Of  erysipelas:  Erysipelas  comes  in  children  from  nature  driving 
the  heated  blood  from  within  to  the  outside  and  comes  at  times  from 
under  the  eyes,  extends  to  the  point  of  the  nose  and  spreads  over  the  face. 
Avicenna  says  the  same. 

Advice:  If  the  child  is  nursing  the  nursing  woman  should  conduct 
herself  just  as  if  she  herself  had  the  fever,  she  should  be  bled  on  the  right 
hand  or  arm,  and  possibly  a  purge  may  be  needed  on  account  of  the  hot 
moistness.  The  child  should  be  given  thistle  water  to  drink;  the  wet- 
nurse  wegwarten,  sorrel  or  prune  water.  Avicenna  says  that  as  soon  as 
erysipelas  appears  and  before  it  spreads,  the  heat  should  be  dissipated 
and  the  pain  lessened  by  cold  water  applied  to  it.  And  Hippocrates  and 
Galen  say:  As  soon  as  erysipelas  has  been  driven  away  and  the  violent 
heat  lessened,  take  care  that  the  erysipelas  is  not  driven  into  the  vital 
parts  and  so  the  child  endangered.  Therefore,  one  should  take  great  care 
that  erysipelas  be  brought  out.  And  if  the  heat  is  not  great  and  one  does 
not  fear  inflammation,  there  is  no  need  of  more  powerful  measures. 
Where  one  is  troubled  in  this  way,  one  should  take  a  cloth  saturated  with 


94  PEDIATRICS  OF  THE  PAST 

fresh  flowing  water  or  cornflower  water  or  nightshade  water  and  apply 
it  according  to  need  One  should  diligently  give  the  above-named  water 
to  drink  that  the  inner  parts  may  be  strengthened,  that  they  receive 
less  of  the  hot  moistness  and  also  that  they  drive  it  out. 

25.  On  eruptions  and  smallpox :  Eruptions  and  smallpox  come  from 
an  inflammation  of  the  blood,  which  drives  out  the  impurities  which  the 
fetus  received  from  the  crude  blood  of  the  mother.  It  should  be  known 
that  the  child  is  nourished  from  the  most  delicate  and  purest  blood  of 
the  mother,  as  Avicenna  says,  and  not  as  others  say  from  the  crude  blood. 
Nevertheless  the  child's  blood  receives  a  mixture  in  his  blood  because  the 
crude  blood  lies  all  about  it;  therefore,  a  child  may  be  cleansed  at  least 
once  before  the  end  of  its  life  by  skin  eruption  or  smallpox.  Similarly 
writes  Avicenna :  If  one  lets  milk  stand  in  a  glass  a  long  time  and  it  is  then 
washed  out  and  the  glass  filled  with  leavened  dough,  the  dough  rises; 
it  is  the  same  with  a  child  and  it  is  good  that  a  child  is  once  cleansed  by  a 
breaking  out  or  by  smallpox.  If  they  are  often  so  affected  it  is  because  they 
are  improperly  cared  for.  Also  eruptions  and  smallpox  most  often  begin 
with  the  second  or  third  year  to  the  seventh  year,  yet  they  may  come 
earlier  or  later  according  as  the  nature  is  inclined  to  drive  out  superfluous 
moisture  or  it  may  come  from  the  influence  of  the  stars. 

The  causes  of  eruptions  and  smallpox  are  twofold :  external  and 
internal.  External,  as  from  the  air;  warm  and  moist  air  does  this.  There- 
fore, it  comes  especially  in  spring  or  the  end  of  autumn,  especially  if  the 
summer  has  been  hot  and  dry.  If,  however,  the  summer  is  warm  and 
moist  then  they  come  at  the  end  of  winter  and  in  spring  as  Rhazes  says. 
They  also  come  at  times  before  epidemics,  then  the  children  die  and 
it  is  called  "rasis."  Internal  causes  are  twofold:  definitive  and  predispos- 
ing. The  definitive  cause  is  that  the  blood  be  cleansed,  the  predisposing 
cause  is  the  overmuch  moisture  in  the  blood  which  irritates  nature  to 
drive  it  out. 

The  signs  of  eruptions  and  smallpox  are  great  heat,  thirst,  headache, 
backache,  heavy  sleep  and  fear,  water  in  the  eyes  and  pain  in  the  extrem- 
ities and  trembling  in  the  legs  if  the  child  tries  to  stand,  there  is  much 
saliva  and  they  toss  about.  These  signs  come  more  by  one  disease  than 
by  the  others.  In  eruptions  the  children  water  more  at  the  eyes  and  they 
have  not  so  much  backache;  in  the  other  they  have  more  heat  and  then 
the  blisters  show  themselves  the  sooner. 

When  one  awaits  eruptions  or  smallpox  in  children  one  should  treat 
the  five  organs;  the  eyes  with  camphor  water  or  beanflower  water  or  rose 
water.  A  small  drop  should  be  instilled  in  the  eye  and  then  a  little  cloth 
wet  with  the  water  laid  upon  the  eyelids;  the  nose  is  painted  inside  and 
out  with  rose  water;  the  mouth  and  larynx  are  sprinkled  with  pomegranate 
juice,  held  in  the  mouth,  also  green  mulberries  rubbed  up  in  water  in 


BARTHOLOMAEUS  METLINGER  95 

which  Italian  grapes  have  been  boiled,  this  is  used  as  a  gargle;  the  lungs 
and  breast  are  sprinkled  with  tragacanth  and  sugar  or  loaf  sugar  is  held 
in  the  mouth  until  it  is  gradually  dissolved.  The  intestines  are  covered 
with  troches  called  "Despodio"  that  is  of  burnt  ivory  of  which  one  gives 
the  children  20  barley  corns  weight,  rubbed  up  with  rose  water,  every 
morning  one. 

Signs  and  differences  of  both  [diseases]  are  visible  on  the  face  and  the 
signs  which  indicate  recovery  or  death  are :  one  should  observe  the  color, 
when  they  are  blue-black  and  dark  they  are  deadly;  if  however,  they  are 
white  or  red  the  outlook  is  favorable,  especially  if  fever  and  shortness  of 
breath  and  other  symptoms  disappear  after  the  smallpox  eruption  comes 
out.  When  this  does  not  happen,  it  is  a  sign  that  they  have  not  all 
appeared.  Also  when  they  break  out  soon  as  on  the  second  or  fourth  or 
seventh  day  after  the  beginning  of  the  disease,  it  is  favorable.  When, 
however,  they  first  appear  on  the  6th  day  they  are  threatening.  Also 
how  many  they  are,  when  they  do  not  grow  in  one  another  or  out  of  one 
another  but  each  one  by  itself,  it  is  favorable.  If,  however,  they  appear 
and  then  strike  in  and  there  is  shortness  of  breath  and  violent  fever, 
the  children  die,  and  one  should  with  great  industry  draw  them 
out  again. 

Advice  in  eruptions  and  smallpox  differs  according  to  the  stage  of  the 
disease:  When  there  is  high  fever,  before  it  manifests  itself,  the  children 
should  be  forbidden  eggs,  wine,  fish  and  meat.  One  should  boil  them 
barley  water  out  of  raw  barley  grains  (about  sixty  grains)  and  four 
sebesten  [fruit  of  the  cordia  myxa]  in  one  measure  [Maass]  of  water 
and  give  this  to  drink  with  syrup  of  pomegranates  or  Agrest  of  Robes. 
And  in  the  meantime  one  should  protect  the  above-mentioned  organs. 
As  soon  as  the  eruption  and  smallpox  begin  to  appear,  the  smallpox  as 
little  blisters  the  size  of  a  millet  seed,  the  eruption  as  redness  of  the  body, 
the  after-described  drink  should  be  given:  Take  6  figs  and  Ientels,  whose 
hulls  have  been  taken  off  by  boiling  them  once,  and  fennel  seeds,  of  both 
1  quintel,  cut  the  figs  and  boil  all  together  in  5  quartlein  of  water  until  it 
has  boiled  away  to  2  quartlein,  and  as  soon  as  it  is  cooled  and  strained, 
it  is  then  to  drink.  And  if  the  drink  should  be  stronger  to  drive  the 
eruption  out,  give  saffron  (3  barley  grains  weight  or  more)  according  to 
need.  The  children  should  be  kept  warm  and  covered  with  a  red  cloth, 
that  it  may  be  drawn  out  on  account  of  the  same  color,  yet  in  such 
warmth  that  the  child  can  bear  it.  One  should  not,  during  this  time, 
give  him  any  watery  fruit  or  drink,  that  they  do  not  get  diarrhea,  as 
dysentery  in  eruptions  is  of  doubtful  outcome.  As  soon  as  the  pocks  are 
ripe  one  should  not  let  them  break  of  their  own  accord  as  the  moisture 
falls  inward  when  the  child  will  be  pock  marked,  but  one  should  open 
them  and  the  safest  way  is  to  use  a  delicate  scissors  and  when  one  takes 


96  PEDIATRICS  OF  THE  PAST 

the  pocks  off  the  skin  and  they  do  not  grow  again,  and  one  should  dry 
them  with  lint.  At  this  time  they  should  not  be  anointed  with  oil,  and  not 
until  they  are  quite  hard  and  have  fallen  off.  If  the  ripe  pocks  do  not  dry 
up,  one  makes  them  dry  with  whortleberries  or  rose  leaves  and  a  linen 
cloth  to  lay  on  may  be  covered  with  millet  or  bean  meal. 

Sometimes  there  are  occurrences  such  as  pain  in  the  hands  and  feet. 
Then  the  children  should  be  placed  awhile  in  warm  water.  If  there  is  any 
place  to  heal  do  it  with  water  salve  or  cold  cream.  One  should  take  great 
care  that  the  children  do  not  scratch  the  pocks  open  as  if  they  do  they 
will  be  pockmarked.  Pockmarks  should  be  treated :  Take  finely  powdered 
litharge,  burnt  calves'  knuckles,  meal  from  chick  peas,  rice  flour,  melon 
seeds,  of  each  the  same  amount,  mix  with  linseed  and  to  a  white  salve. 
In  the  evenings  anoint  the  child's  face  and  in  the  morning  wash  it  off 
with  a  little  bag  of  bran,  that  has  been  wet  in  water  in  which  violets  or 
poplar  leaves  have  been  boiled;  and  this  should  be  done  morning  and 
evening  as  long  as  it  is  necessary. 

It  should  also  be  known  that  the  children  frequently  have  warts, 
glands  and  other  growths,  but  it  is  not  necessary  to  advise  about  them  as 
for  the  most  part  they  disappear  with  increasing  years;  if  this  does  not 
happen,  then  one  must  have  advice  concerning  them;  and  here  ends 
the  third  chapter. 

The  fourth  part  tells  how  children  should  be  brought  up  from 
the  time  that  they  learn  to  walk  and  talk  until  they  reach  the 
age  of  seven  years. 

Galen  says:  When  children  learn  to  walk  care  should  be  taken  that 
they  do  not  put  out  of  joint  the  feet  or  back.  When  the  mother  fears  that 
her  child  will  not  walk  soon,  one  should  seethe  in  water  the  roots  upon 
which  Kabaskraut  [?]  grows  and  wash  the  children's  feet  and  hips  morn- 
ing and  evening.  When  children  understand  admonitions,  as  soon  as  they 
get  up  in  the  morning  they  should  be  given  food.  After  the  bath  they 
should  be  allowed  to  play;  and  when  they  wish  more  to  eat  they  may  be 
bathed  but  never  on  a  full  stomach.  Up  to  the  seventh  year  mush  and 
milk  may  be  given  between  the  other  meals  which  should  be  light  on 
account  of  the  child's  growing.  Sweat  baths  are  not  healthy  for  them. 
They  should  not  be  sprayed  with  cold  water  as  internal  diseases  may  be 
caused  and  external  ones  hindered.  Also  Averroes  says  cold  water  hinders 
growth. 

Great  care  should  be  taken  to  inculcate  good  habits,  as  Aristotle  says : 
"Assiduous  industry  becomes  a  habit  but  anxiety,  anger,  ill  humor, 
fear,  sadness  and  over  much  waking  should  be  avoided  and  the  child's 
attention  directed  to  things  which  please  and  turned  aside  from  that 
which  troubles.  They  should  also  be  brought  up  to  be  obedient  to  their 


BARTHOLOMAEUS  METLINGER  97 

parents  and  reverent  to  God,  as  good  habits  make  for  a  good  nature." 
Avfcenna  mentions  this:  "Bad  habits  are  a  sign  of  a  bad  streak  in  the 
nature.  Anger,  hot  headedness,  sadness,  fear,  coldness,  anxiety  and  ill 
temper  make  for  stubbornness.  Growing  too  fast  is  the  beginning 
of  many  diseases.  Also  becoming  accustomed  to  good  habits  is  necessary 
both  for  body  and  soul."  And  Aristotle  says:  "The  soul  of  a  child  is  an 
unwritten  tablet  upon  which  nothing  is  written,  one  may,  however, 
write  upon  it  what  one  will."  Therefore  one  should  gradually  but  regu- 
larly accustom  badly  mannered  children  to  good  habits  by  kindness 
and  punishment  until  their  natures  are  formed. 

It  should  be  known  that  children  should  not  be  too  severely  punished, 
Valerio  writes  of  one  called  Mancilio  Torquato  who  drove  his  son  out  of 
the  house  because  he  had  taken  money  by  stealth;  the  son  through 
grief  went  and  hanged  himself.  In  modesty  and  goodness  should  parents 
bring  up  their  children.  Parents  should  watch  over  their  children  as  the 
same  Valerio  describes  how  the  son  of  King  Antioch  was  mad  out  of 
unpermitted  desire  for  his  step-mother.  His  father  noted  this  and  led 
him  to  another  woman  thereby  avoiding  great  evil.  Punishment  is  to  be 
praised  when  it  is  just  and  not  too  severe  and  a  small  fault  in  a  child  may 
be  overlooked  to  prevent  some  greater  one. 

It  should  be  marked  that  children  who  have  reached  six  years  should 
be  sent  to  a  teacher  to  be  taught.  They  should  not  be  kept  at  it  contin- 
ually but  have  recesses.  Of  this  King  Octavius  has  written;  he  educated 
his  son  in  knightly  exercises  and  his  daughter  learned  embroidery  on 
silk.  Even  if  the  child  from  birth  and  inheritance  has  what  he  needs,  he 
should  be  as  industrious  and  wise  as  if  he  did  not  have  property  or 
desired  more  as  through  the  exercise  of  such  virtues. 

Also  one  should  not  bathe  children  too  much  in  cold  water  as  is 
done.  They  should  be  allowed  to  get  hungry  before  they  are  fed.  If 
they  are  fed  on  mush  and  milk  they  do  not  need  any  drink;  but  if  they 
are  on  other  food,  as  meat,  they  should  be  given  water  to  drink.  They 
should  be  watched  carefully  for  two  or  three  hours  after  eating. 

Of  whether  or  not  to  give  wine  to  children,  it  should  be  understood 
that  they  are  to  have  no  wine  until  they  arrive  at  the  age  in  which 
nature  begins  to  assert  itself,  that  is  twelve  in  women  and  fourteen 
for  men.  The  nature  of  children  is  in  the  moistness  of  their  extremities, 
from  which  they  grow.  Now  as  wine  is  hot  and  dry  in  its  nature  so  it 
disturbs  the  constitution.  Also  Galen  says:  "Healthy  children  should 
drink  no  wine  as  it  heats  them  and  overmoistens  the  head  and  they 
get  watery  heads  out  of  which  many  diseases  originate  and  they  are 
excited  in  spirit  and  become  angry  easier."  When,  however,  they  reach 
the  above  mentioned  age,  it  is  healthful  to  drive  out  the  superfluity  of 
fluid  out  of  the  body  through  the  urine  and  sweat  and  to  nourish  them 


98  PEDIATRICS  OF  THE  PAST 

well.  Therefore,  it  is  not  wise  to  give  children  wine  as  it  does  not  help 
them  but  is  very  harmful.  Water,  however,  does  no  harm  especially  in 
hot  children.  Also  Averroes  says:  "Wine  and  beer  are  harmful  to  children 
as  it  fills  their  heads  with  bad  heat  and  clouds  their  spirit."  Some 
masters,  however,  write  that  children  may  be  given  mixed  wine,  as 
for  example  Avicenna  in  another  chapter:  "Little  wine  and  much  water 
and  only  cold  (not  excitable)  children,"  as  he  also  says:  "Wine  is  not 
to  be  given  to  children  especially  if  they  are  hot  (excitable)  and  full- 
blooded  on  account  of  the  reasons  given  above." 

And  further  it  should  be  remarked:  As  the  moistness  lessens  with 
increasing  age  and  the  strength  of  the  limbs  is  greater,  children  may  be 
taken  about  more  and  may  have  coarser  food.  Also  exercises  carefully 
measured  for  the  increasing  age  should  be  undertaken  so  that  the  limbs 
of  the  children  grow,  though  the  food  and  the  superfluous  moisture 
may  be  driven  off  by  the  exercise  and  the  children  thus  remain  in  health. 

And  with  this  the  fourth  chapter  and  the  little  book  end. 
[See  also  Jonas  and  Raynalde,  and  Louffenburg.] 


CORNELIUS  ROELANS 

[1450-1525] 

THE  third  pediatric  incunabulum  is  a  very  rare  book.  There 
are  copies  in  the  Hunterian  Museum  in  Glasgow  and  in  the 
library  of  the  University  of  Leipsic  and  a  few  leaves  in  the 
library  at  Cambridge,  England.  The  work  is  referred  to  as  a 
Bucblein  and  it  was  evidently  printed  and  bound  with  some  other 
work,  a  common  enough  custom  in  the  days  when  it  was  issued 
from  the  press.  What  this  other  work  was  is  not  known.  The  work 
of  Roelans  is  evidently  complete.  The  work  is  a  folio  of  small  size 
beginning  at  lxxviii  and  ending  with  cxcim.  There  are  1 17  printed 
leaves  and  one  blank  page.  According  to  Jenkinson  of  the  library 
at  Cambridge,  England,  the  printer  was  J.  Veldener  of  Louvain. 
The  work  is  dedicated  to  Philip  1,  the  Handsome,  of  Burgundy, 
Brabant  and  Flanders.  The  author's  name  appears  in  the  twenty- 
second  line  of  the  second  page. 

Roelans  (or  Roelants)  was  born  in  1450  in  Mechlin  and  in 
1466  entered  the  University  of  Lowen.  He  subsequently  returned 
to  Mechlin,  married  Caecilie  von  Duffel  in  1494  and  had  two 
children.  From  1498  to  1525  he  was  "Hospital  und  Stadtarzt." 
He  died  September  1,  1525. 

Sudhoff  has  contributed  two  illuminating  articles1  on  the  sub- 
ject of  Roelans  and  his  work  and  a  search  of  the  literature  of 
the  period  as  well  as  before  and  later  revealed  a  considerable 
amount  of  material  concerning  his  life  and  the  sources  from 
which  he  derived  the  material  for  his  "aggregatio."  The  book  has 
no  title  page  but  starts  on  the  first  line:  Prefacio  in  Iibellu  egri- 
tudini  infantum.  Sudhoff  is  of  the  opinion  that  Roelans  in  his 
younger  days  must  have  studied  assiduously  the  manuscripts  of 
the  Netherlands  not  only  in  Louvain  but  in  other  universities  and 
possibly  also  in  Italy. 

Roelans   cites   a   remarkable  array  of  medical   authorities. 
The  prognostics  and  the  aphorisms  of  Hippocrates;  frequently 
Galen,  occasionally  Dioscorides,  Rufus  and  Sextus  Placidus;  of 
1  Sudhoff,  K.  Janus,  1909,  xiv,  467;  1915,  xx,  443- 

99 


ioo  PEDIATRICS  OF  THE  PAST 

the  Arabians,  Avicenna,  Rhazes,  Mesue,  Serapion,  Honein, 
Avenzoar,  Hali  Abbas  and  a  great  row  of  medieval  commentators, 
Johannes  Matthews  de  Gradi,  Nicolaus  Florentinus,  Solanus, 
Jacobus  of  Forli,  Gentile  de  Fulgineo,  Franz  von  Piemont, 
Marsilius  de  Sancta  Sophia  and  Jacques  Despars.  The  range  is 
wide  and  mention  is  made  of  Gerardus  Cremonensis,  the  "Con- 
ciliator" of  Peter  of  Abano,  the  "Lilium"  of  Bernhard  von 
Gordon,  the  "Regimen  Sanitatis,"  John  of  Gadesden's  "Rosa 
Medicinae,"  Gilbertus  Anglicus,  Arnold  of  Villanova  and  others. 
But  amid  all  these  names,  all  these  formidable  authorities, 
Roelans  recurs  to  "the  little  book  on  diseases  of  children* '  as 
"In  alio  tractulo  aegritudinum  puerorum,"  or  "in  quodam  parvo 
antiquo  authore  de  passionibus  puerorum"  and  in  other  similar 
phrases.  The  little  book  and  its  sources  have  been  commented 
upon  elsewhere  in  this  volume. 

His  authorities,  quoted  and  discussed  at  length,  show  how 
little  he  had  broken  away  from  the  bonds  of  scholasticism  and 
authority.  It  was  the  fault  of  his  age,  as  it  is  indeed  too  much  of 
ours,  though  there  are  few  who  would  admit  it.  Bagellardus  was 
the  same,  while  in  Metlinger  we  see  a  much  greater  tendency 
to  original  observation  and  description. 

Roelans*  work  has  an  historical  value  above  his  own  observa- 
tions and  opinions  and  this  lies  in  the  tact  that  he  searched  dili- 
gently the  older  writers  and  has  picked  out  the  pediatric  portions. 
His  book  does  for  medieval  literature  what  the  editor  has  tried 
to  do  in  part  for  a  longer  period.  Naturally  the  scope  of  his  work 
was  limited  and  he  reprinted  only  what  seemed  best,  but  his 
references  give  one  a  very  good  idea  of  the  trend  of  pediatric 
thought  in  his  day  and  before.  Roelans  found  only  fifty-two  diseases 
mentioned  by  the  older  writers,  which  he  lists.  The  most  frequently 
quoted  author  is  Avicenna  and  in  connection  with  him  frequent 
reference  is  made  to  Jacques  Despars,  a  physician  of  Paris,  credited 
with  an  early  description  of  petechial  fever.  He  wrote  a  long 
treatise  on  Avicenna  and  divided  the  books  into  chapters.  He 
publicly  denounced  the  abuse  of  the  public  baths  and  was  so 
persecuted  by  the  bathers  that  he  withdrew  to  Tournay  where  he 
died  in  1465. 

The  part  of  the  section  on  the  cure  of  hydrocephalus,  the 
third  disease  to  be  considered,  may  be  read  as  a  sample  of  medieval 
therapeutics.  If  it  sounds  unreasonable,  read  some  of  the  writings 


tf  foqufofot  qualf  luminal  qua  ru^ate^,, 

fa  g^rawlcal«eiAflr«iiioluaogencianirqucadai 
dm  traitfmffla  gcneracfo  toto  «d  to  alfqua  partecoroo 
tf  a  fnflatfcmem  ^Signapatem  ^Curad  ifVgfmm 
numa  «npetamiiiftittnga«»ttincrnfano«enirrtme 
dio  quod  in  quodam  IfbeOo  egrftudinum  pueromm  i 

ttmi1Wpefiiimtitett8rambudtt*uli(oquei'«wVo 
altoetpannfocau'dia  pucmmmuolucreutndumtota 
ttl  leamdum  partem  epuhnmando  fie  topic  eu 
•T^ufoquagcfimafeamda  cgrfmdo  puerosim  et  rt 
dma  eft  ntmea  madlenda  feu  epenuatio  pucromm 
'^n  qtiodam  lifeflo  egriradi'mi  puero$ 

"^  3 wropuer  fit  nimio  madlctuuo babat 
^Btantum  olfe  etptflem  etmultufittebilf/ 
tatuaCpTura  eft  fiat  ei  tale balneum  & 
_/  caput  arierfo  et pedeo  coquan wr frt  aqua 
~  ..jctp  cameo  feparentr  ab  offibuo  tti'n  calf  aqua  m 
cano  batneemr  et  aim  ep'erft  a  batoeo  tali  wigenro  pn 
guarar  ttodpeBunrf  old  rofatf  vd  rfofatf  vd  coiroirtia 
aua*$»  jer*et  eepfoguedine  cruda  tz  camibucpodnta  $ 
%  cere  a!te-$»wq.  qualftwoie port  crftum  balnrfwgin 
tnr  torn  cc«puo  hoc  wiguento  ecmultu  fitpfnguar 

•Jj&fic  dlfirtfocapitu'i-aregi'mutefnfeRtfa 


A  page  from  Roelans'  book.  (Courtesy  of  Professor  Sudhoff.) 


102  PEDIATRICS  OF  THE  PAST 

on  the  use  of  the  endocrine  glands  in  present  day  therapeutics. 
Roelans  suggests  that  the  treatments  recommended  be  used  only 
in  very  strong  children  or  by  preference  on  the  nurse,  a  common 
enough  procedure  in  those  days  and  one  to  which  they  doubtless 
owed  much  of  their  success. 

The  following  translation  was  made  for  the  author  by  Dr. 
Herbert  Francis  Wright  of  Washington,  D.  C,  from  a  photostat 
copy  kindly  furnished  by  Professor  Sudhoff.  The  portion  given 
here  is  about  the  first  half  of  the  work. 

ON  DISEASES  OF  INFANTS 

BY  CORNELIUS  ROELANS 
PREFACE 

To  the  little  book  of  diseases  of  infants. 

Those  who  benefit  public  utility  are  said  to  benefit  Your  Sereneness, 
Philip,  most  invincible  of  princes  and  glory  of  leaders.  Here  I,  distressed 
at  the  very  great  carelessness  concerning  diseases  of  infants,  have 
thought  to  compile,  from  the  volumes  of  original  men  especially  doctors 
of  medicine,  a  treatise  or  little  book  of  children's  diseases,  by  means  of 
which  they  may  be  kept  safe  from  falling  ill  or  having  fallen  ill  may  be 
kept  safe  from  death.  For  thereby  they,  by  God's  assistance,  may  grow 
into  men,  who  may  worthily  honor  thy  person  as  thou  so  richly  deservest, 
and  having  honored  may  preserve  it  from  all  danger.  For  thou  art  the 
only  one  whom  our  great  lands  adore,  venerate  and  love  as  if  sent  from 
Heaven,  thou  who  art  the  sacred  stock  of  so  noble,  so  wonderful  and  so 
distinguished  a  King  of  the  Romans,  Maximilian.  We  hope  therefore 
that  thy  character,  so  excellent  in  so  tender  an  age  as  this,  will  proclaim 
thee  worthy  of  being  placed  first  among  all  illustrious  lords.  We  await 
thee  as  the  guardian  of  the  commonwealth,  we  await  thee  as  the  enlight- 
ener  of  all  leaders.  We  hope  thou  wilt  be  the  refuge  of  all  monarchs 
[and]  pontiffs.  Not  therefore  without  reason  have  I  thought  that  this 
little  book  should  be  inscribed  to  thy  name  and  thy  sereneness,  since 
thou  considerest  it  among  the  accumulation  of  thy  honors  for  the  public 
good  [that]  a  useful  and  advantageous  work  be  compiled,  but  although 
this  compilation  of  so  insignificant  a  man  as  Cornelius  Roelans  of 
Mechlin,  the  least  of  all  the  doctors  of  medicine,  may  not  be  pleasing  to 
thee,  yet  I  hope  that  the  matter  will  turn  out  successful  and  therefore 
pleasing  to  public  utility.  And  that  it  may  be  so,  I  pray  the  doctor  of  all 
good  men,  the  Lord  Jesus  Christ,  be  propitious  to  us,  that  His  customary 
grace  may  assist  me.  Amen. 


CORNELIUS  ROELANS  103 

ON  DISEASES  WHICH  OCCUR  IN  INFANTS  OR  CHILDREN 

Now  I  find  that  from  the  volumes  of  different  authors  I  could  gather 
fifty-two  species  of  children's  diseases  which  I  shall  run  through  briefly. 
Avicenna2  says:  "The  first  thing  (intentio)  in  curing  infants  is  to  regu- 
late the  nurse."  And  if  there  shall  have  been  added  the  suspicion  that 
in  her  there  is  a  repletion  of  blood,  she  (sc,  the  nurse)  ought  to  be  dimin- 
ished, i.e.,  she  should  be  phlebotomized  or  cupped.  And  if  the  repletion 
has  been  due  to  humor,  she  should  be  evacuated.  But  if  it  shall  have  been 
necessary  to  bind  or  loose  nature  or  ward  off  vapor  from  the  head  or 
rectify  the  members  of  breathing  or  to  change  bad  complexion,  the  cure 
should  be  made  through  those  remedies  which  are  eaten  or  drunk  which 
may  be  suitable  for  the  purpose.  Sometimes  she  (sc,  the  nurse)  will  be 
cured  by  a  loosening  of  the  bowels  or  the  bowels  will  have  come  to  this 
by  nature,  i.e.,  a  flow  of  the  bowels,  and  it  will  have  been  much,  or  she 
(sc,  the  nurse)  will  be  cured  by  vomiting  or  it  will  have  come  to  her 
naturally  and  vigorously.  It  will  be  better  that  another  (sc.  healthy) 
mother,  says  Jacques  Despars,  nurse  it  (sc.  the  infant),  until  the  distur- 
bance of  the  blood  and  milk  of  its  own  nurse  shall  have  been  quieted  after 
the  turmoil  of  the  purgation. 

Cornelius  Roelans,  the  compiler  of  the  work,  says:  Having  from  differ- 
ent sources  treated  briefly,  incompletely  and  without  order  children's 
diseases  and  those  which  can  occur  in  infants,  I,  in  confirmation  of  my 
zeal,  for  the  consolation  of  new  practitioners  of  medicine  and  for  satis- 
fying the  useful,  proper  and  insistent  demand  of  certain  persons,  having 
invoked  the  grace  of  the  bountiful  [Lord]  have  been  delighted  to  compile 
them  in  a  certain  order  descending  from  the  diseases  of  the  head  or  upper 
members  to  the  diseases  of  the  feet  or  lower  members  to  the  number  of 
fifty-two,  as  the  following  table  will  show. 

TABLE  OF  52  SPECIES  OF  CHILDREN^  DISEASES  FROM  THE  HEAD  TO 

THE  FOOT 

Page 

1 .  On  apostema  of  the  children's  cerebrum  and  on  siti- 
bundum  or  erysipelas  on  their  cerebrum  lxxx 

2.  On    apostemata    which    are    outside  the  children's 
cranium  lxxxii 

3.  On  water  gathered  in  the  children's  head  lxxxiii 

4.  On  wind  or  inflation  of  the  children's  head  lxxxviii 

5.  On  largeness  of  the  children's  head  xci 

6.  On  saphati  of  children  xcn 

7.  On  favosity  of  sweetness  of  children  and  it  is  a  species  of 
saphati  xcvi 

2  Bk.  1,  fen  in,  doct.  i,  ch.  iii. 


04 


PEDIATRICS  OF  THE  PAST 


8. 
9- 

10. 

ii. 

12. 

13- 

14. 

15. 

l6. 

17. 

18. 
IQ. 

20. 
21. 
22. 


23- 
24. 

25. 
26. 

27. 
28. 

29. 
30. 
31. 
32. 

33- 

34. 
35- 
36. 

37- 
38. 

39- 
40. 
41. 
42. 


On  wakefulness  or  insomnia  of  children 

On  fear  in  dreams  of  children  or  on  nightmares 

On  epilepsy  of  children  or  on  the  disease  which  is  called 

"the  mistress  of  children" 

On  relaxation  of  children's  nerves 

On  spasm  of  children 

On  alcuzen,  otherwise  cuzen,  of  children,  i.e.,  tetanus 

On  spasm  and  tetanus  from  inanition  of  children 

On  whiteness  in  the  children's  pupils 

On  inflation  of  children's  eyes 

On  strabosity  of  the  eyes,  i.e.,  on  obliqueness  of 

children's  vision 

On  weeping  and  tears  of  children 

On  sulac  of  children  or  on  closure  of  the  eyelids  of 

children 

On  scabies  of  children's  eyes 

On  earache  of  children 

On  the  flow  of  humors  from  children's  ears  or  on 

humidity  flowing  from  children's  little  ears  or  on  bloody 

discharge  from  their  little  ears 

On  poisonous  discharge  from  children's  little  ears 

On  sneezing  of  children 

On  fissures  of  children's  lips 

On  diseases  of  the  teeth  of  children 

On  apostema  of  children's  gums 

On   sharpness,   pustules   or  boils,  pain  and  itching  in 

gums  of  infants  or  children 

On  alcola,  i.e.,  on  pustules  of  the  children's  mouth 

On  cancer  in  the  mouth  of  children 

On  apostema  of  the  throat,  i.e.,  on  quinsy  of  children 

On  cough  or  rheumatism  of  children 

On  badness  or  difficulty  and  stoppage  of  breathing  of 

children 

On  oregmon  of  children 

On  weakness  of  the  stomach  of  children 

On  vomiting  of  children 

On  hiccup  of  children 

On  belly  ache  of  children 

On  looseness  of  the  bowels  of  children 

On  constriction  or  constipation  of  the  bowels  of  children 

On  worms  or  Iubrica  of  the  belly  of  children 

On  apostema  or  protrusion  or  inflation  of  the  umbilicus 

of  children 


xcvi 
xcix 

c 

cm 
cm 
cvn 

CVIII 

cix 
ex 

CXI  I 
CXV 

CXVII 
CX IX 
CXXIII 


exxv 

CXXVII 
CXXVII 

exxx 

CXXXII 
CXXXII 

exxxv 

CXXXVII 
CXLI 
CXLIV 
CXLVIII 

CL 

CLI 

CLII 

CLV 

CLVIII 

CLX 

CLXII 

CLXVI 

CLXVIII 

CLXXI 


CORNELIUS  ROELANS  105 

43.  On  stone  in  the  bladder  of  children.  clxxii 

44.  On  rupture  of  the  peritoneum  or  on  swelling  or  inflation 

in  the  groin  of  children  clxxiii 

45.  On  projection  of  the  intestines  or  anus  of  children  clxxix 

46.  On  tenesmus  of  children  clxxx 

47.  On  excoriation  on  the  hips  of  children  or  on  softness 
causing  excoriation  on  their  hips  or  on  itching  or  boils  on 

the  hips  of  infants  clxxx  11 

48.  On  weakness  in  progressive  motion  of  children  clxxxiii 

49.  On  pustules  or  buttons  on  the  entire  body  of  children 
among  which  are  smallpox  (variolae)  and  measles  clxxxvi 

50.  On  fever  of  children  cxcm 

51.  On  inflation  of  the  entire  body  of  children  cxcm 

52.  On  excessive  wasting  away  or  thinning  out  of  children 

and  this  is  the  last  species  of  their  diseases  cxciv 

That  the  order  of  procedure  of  the  compilation  of  diseases  of  children 
or  infants  may  be  understood,  I,  the  compiler,  shall  explain  it  brieffy. 
1.  The  name  of  the  disease  will  be  stated;  2.  the  causes;  3.  the  symptoms; 
4.  the  prognostics;  5.  the  cure  according  to  the  opinions  of  the  most 
experienced.  Although  the  subject  matter  of  the  work  will  be  quite  com- 
prehensive, yet  its  newness  and  pleasure  and  the  rareness  of  its  blossom- 
ing forth  in  the  open  (of  which  Mesue3  makes  mention  speaking  of 
fumitory:  "But  because  of  its  exuberance  it  is  excepted  from  the  number 
of  precious  medicines") — on  the  contrary  on  the  basis  of  exuberance  the 
rarity  of  this  subject  will  cause  it  to  be  placed  among  the  choicest  of 
subjects,  according  to  that  dictum  that  everything  rare  is  dear.  I  hope, 
considering  the  insignificance  and  inexperience  of  the  compiler  Cornelius, 
this  compilation  will  not  be  despised,  but  in  the  words  of  Seneca,  let  not 
the  authority  of  the  speaker  move  you  and  attend  not  to  who  is  speaking 
but  to  what  is  spoken.  When  all  applause  has  been  considered,  it  will  be 
preserved  and  will  be  approved  by  the  most  experienced  as  very  tasty. 

End  of  the  Preface  of  the  little  work  on  children's  diseases. 

The  first  disease  of  infants  or  children  is  apostema  of  the  head  or 
cerebrum,  called  by  the  eminent  Avicenna4  sitibundum  and  by  the  same 
authority5  erysipelas. 

Avicenna4  [says]:  "In  the  cerebrum  of  the  infant  occurs  a  warm  apos- 
tema and  it  is  called  sitibundum."  The  storehouse  of  modern  doctors, 
Jacques  Despars,  says  sitibundum,  either  because  it  draws  humors  to 
itself  as  if  full  of  wind  or  because  an  acute  fever  accompanies  it  and  a 

3  De  consolatione  medicinarum.  bk.  II,  ch.  xiv,  of  approved  medicines. 

4  Bk.  1,  fen  iii,  doct.  I,  ch.  iii. 

6  Bk.  in,  fen  i,  tractate  3,  ch.  v. 


io6  PEDIATRICS  OF  THE  PAST 

strong  drying  of  the  throat  and  tongue  and  orifice  of  the  stomach  into 
which  it  is  introduced  thus,  resulting  in  injurious  leanness  if  it  has  been 
caused  by  the  cholera. 

Avicenna6  says  children  sometimes  have  erysipelas  in  the  cerebrum. 
Gentile  hereon  says  erysipelas  is  the  general  name  of  choleric  apostemata. 
Its  cause,  says  Gentile,  is  choleric  matter  pure,  i.e.,  not  burned  with  a 
burning  that  makes  it  decline  to  blackness  because  then  it  would  be 
sibare  and  of  demons.  Sibaret  says  Gentile,  i.e.,  mania  from  manes 
or  demon,  on  which  [see]  Avicenna.6 

The  symptoms  are: 

Avicenna7  [says]  often  its  pain  reaches  the  eyes  and  throat  and  hence 
the  face  becomes  citrine. 

Jacques  Despars  says  it  reaches  the  eyes  or  the  eye  on  account  of  the 
great  connection  of  the  nerves  with  the  eyes  through  the  great  and  oppo- 
site optic  nerves.  The  pain  of  this  apostema  reaches  the  reverse  nerves  of 
the  throat  which  stretch  from  the  cerebrum  to  the  throat,  but  also  reaches 
the  orifice  of  the  stomach,  according  to  the  statement  of  Galen:8  "The 
stomach  affects  the  head  in  suffering  and  the  head  the  stomach."  The 
reason  is  the  size  of  the  nerve  descending  from  the  head  to  the  mouth  of 
the  stomach  and  on  account  of  this  nerve  the  mouth  of  the  stomach 
is  more  sensible  to  all  the  members  of  the  body.  The  face  is  citrinated, 
if  apostema  is  choleric.  If  bloody,  it  will  be  very  red. 

Rasis9  lays  down  the  symptoms  whereby  such  an  apostema  is  recog- 
nized saying,  when  distress  has  attacked  someone  and  there  is  in  the  head 
and  eyes  a  great  heaviness  and  in  the  face  and  eyes  an  intense  redness  and 
pain  in  the  head  and  horror  of  light  and  in  the  pulse  an  excessive  quick- 
ness is  found,  these  will  be  considered  the  surest  symptoms  of  frenzy, 
because  if  the  tongue  is  black  instead  of  yellow  and  loses  sensation  and 
there  is  much  delirium  and  wakefulness,  frenzy  is  already  at  hand. 
Avicenna10  says  the  sinciput  is  caused  to  flow  with  this  very  erysipelas. 
Gentile  Fulginas  hereon  says:  "The  sinciput,  i.e.,  japhet,  or  the  place  of 
the  fontanel  of  the  head,  i.e.,  the  anterior  part  of  the  head  or  the  part  of 
the  forehead  and  eyes,  is  also  caused  to  flow  and  the  eye  (sc.  one)  waters 
and  the  entire  body  is  dried  up."  Niccoli11  says  that  the  entire  body  is 
dried  up  on  account  of  the  intense  heat  and  that  this  drying  up  of  the 
head  and  eyes  and  entire  body  also  happens  even  at  other  ages  than 
childhood,  but  the  authorities  have  rather  explained  it  concerning 
children  because  it  occurs  in  them  more  generally  and  more  quickly  since 

•  Bk.  in,  fen  i,  tractate  3,  ch.  vi. 

7  Loc.  cit.,  canon  l. 

8  Interiora,  in,  ch.  xii. 

9  On  ix  Almansoris,  ch.  iii. 
wLoco  dicto,  can.  in. 

11  Sermo  in,  tractate  ii,  summa  4,  ch.  iii. 


CORNELIUS  ROELANS  107 

they  are  more  open  to  dissolution  and  consumption.  Gordon12  says:  "In 
this  affection  the  eyes  pain  and  become  citrine  and  the  face  also  becomes 
citrine." 

Prognostic  Symptom.  Avicenna13  says  most  of  it  (sc.  erysipelas) 
destroys,  i.e.,  kills,  on  the  third  day  and,  if  it  does  not  kill,  it  departs, 
i.e.,  it  may  depart. 

Cure.    Avicenna14  lays  down  five  remedies. 

The  first  is,  says  Avicenna,  that  its  (sc.  the  infant's)  head  is  to  be 
cooled  and  moistened  with  the  barks  of  cucurbita  and  citrollus,  otherwise 
citrullis.  Jacques  Despars  comments  hereon :  It  ought,  however,  be  placed 
upon  the  forehead,  the  temples  and  the  crown  joint,  so  that  by  their 
coolness  and  moistness  they  might  dissipate  the  choleric  matter  of  the 
apostema  and  grow  quiet  after  boiling  and  invite  sleep  and  lessen  the 
fever.  And  because  the  elimination  of  the  malignant  matter  can  be 
effected  in  infants  neither  by  phlebotomy  nor  by  pharmacy,  on  account 
of  the  weakness  of  their  powers,  it  is  proper  that  rubbings  and  bindings 
of  the  extremities  be  made  for  the  sake  of  scattering  the  matter,  lest  all  of 
it,  through  the  administration  of  the  cooling  things,  settle  in  the  head. 

The  second  remedy  is  the  juice  of  nightshade  (solatrum)  or  morella 
smeared  upon  the  temples,  says  Jacques  Despars,  and  on  the  forehead 
and  crown  joint  or  soaked  into  a  linen  cloth  and  placed  upon  the  head. 

The  third  is,  says  Avicenna,15  the  juice  of  real  portulacca;  similarly 
applied,  said  Jacques. 

The  fourth  is  oil  of  rose  with  a  dash  of  vinegar  shaken  well  so  as  to 
make  the  virtue  of  the  oil  penetrate  and  by  cooling  assist  it.  For  this 
remedy  vigorously  lessens  the  pain  of  the  head,  checks  the  heat, 
strengthens  the  cerebrum  and  prevents  the  smoky  vapors  moving  toward 
the  cerebrum. 

The  fifth  is  the  yolk  of  an  egg  beaten  and  mixed  with  oil  of  rose.  For 
it  assuages  the  pain,  dissipates  the  matter  and  dissolves  some  of  it. 

Finally,  Avicenna  says,  should  you  apply  some  of  these  remedies,  do 
not  stop  there  for  a  long  time,  but  continually,  says  Jacques,  change  and 
renew,  because  they  quickly  become  overwarm  and  the  virtue  of  cooling 
and  moistening  is  borne  away  through  the  heat  of  the  apostema  unless 
they  are  actually  applied  cool  and  continually  removed. 

Avicenna16  speaks  to  the  same  effect.  Let  them  (sc.  the  children)  be 
healed  with  the  yolk  of  an  egg  (sc.  mixed)  with  oil  of  rose;  cooled  and 
changed  every  hour,  Niccoli  of  Florence17  says,  in  order  that  it  may  not 

11  Regis  sanitas,  ch.  iv. 

13  Loco  dicto,  can.  Hi. 
1ALoco  dicto,  can.  i. 
11  Loc.  cit. 

14  Loco  dicto,  can.  in. 
17  Loco  dicto. 


108  PEDIATRICS  OF  THE  PAST 

become  warm  and  having  become  warm  impart  its  warmth.  And  this  is 
appropriate,  because  it  extinguishes  and  assuages  the  pain. 

Afterwards  Avicenna  says :  And  (sc.  let  it  be  healed)  with  compresses, 
i.e.,  cool  and  moist  juices  and  moist  and  cool  herbs  upon  the  head  prop- 
erly with  the  barks  of  melon  melonis  and  of  citrullus  and  with  cucurbita. 

Niccoli18  says:  Indeed  they  hollow  out  the  center  of  the  cucumber  and 
place  it  upon  the  head.  For  they  cool  and  moisten  and  can  be  applied  in 
the  beginning  because  they  drive  out  the  matter  with  their  coolness. 

Gordon  19  says  especially: 

1$  albuminis  ovi,  aquae  rosatae  et  olei  rosati  ana 

aceti  parum 

Mix  and  place  a  linen  cloth  dipped  in  it  upon 
the  head. 

And  if  it  is  very  unresponsive : 

1$  succi  solatri,  cucurbitae,  citrulli  et  olei  rosacei       ana 
In  equal  parts  and  as  if  lukewarm. 

The  second  disease  of  children  is  apostema  which  is  attached  outside 
the  cranium  of  children  and  is  called  by  Gentile20  atas  or  atasum,  i.e., 
warm  apostema  outside  the  cranium  of  children.  There  occur  sometimes 
warm  and  cold  apostemata  in  the  coverings  which  are  outside  what  he 
calls  the  head.  Avicenna,  not  to  the  contrary,  says  this  disease  (says 
Gentile  hereon,  sc.  water  and  apostemata)  is  humidities  retained  between 
the  cranium  and  the  cutis  and  between  the  two  external  membranes. 
An  explanation  of  this  will  be  clear  from  the  third  (sc.  the  following) 
disease  of  children.  Gentile  on  Avicenna21  says  atas  or  atasum  (sc.  in 
Arabic)  is  a  warm  apostema  outside  the  cranium  and  swelling,  or  infla- 
tion, which  appears  on  the  heads  of  infants.  The  gathering,  in  so  far  as  it 
is  a  warm  apostema  outside  the  cranium,  as  Gentile  says,  is  put  here 
under  this  second  disease,  and  in  so  far  as  it  is  wind  distending  the  heads 
of  infants,  as  Jacques  Despars  says,  is  put  under  the  fourth  disease. 
Gentile  on  this  passage  of  Avicenna  says  that  Avicenna  shows  the  cause 
of  the  generation  of  warm  and  cool  apostemata  outside  the  cranium, 
when  he  says  that  sometimes  there  are  humors  from  watery  humidities, 
namely,  those  which  flow  to  places  between  the  cranium  and  the 
cutis,  whether  they  flow  on  account  of  a  violent  compression  or  from  some 
other  causes  whereby  the  members  receive  matter,  and  then  those  humors 
make  apostemata  which  are  not  watery. 

11  Loco  ditto. 

19  Loco  dicto. 

20  Avicenna,  bk.  Ill,  part  i,  tractate  3,  ch.  11. 

21  Loc.  cit. 


CORNELIUS  ROELANS  109 

The  symptoms  of  apostemata,  Avicenna22  after  some  process, 
mentions.  If  first,  the  color  of  the  skin  is  changed  from  its  natural  color 
because  the  cool  or  warm  humoral  matter  of  the  apostema  changes  the 
color.  And  secondly,  the  touch  is  different  because  Gentile  says  that  in  a 
warm  apostema  it  is  warm,  in  a  cool  one,  cool,  or  different,  sc.  from  the 
touch  of  water  of  which  [we  shall  speak]  at  once.  And  thirdly  there  is 
there  a  strength,  i.e.,  a  resistance  and  prevention  as  regards  expelling, 
i.e.,  says  Gentile,  it  prevents  expulsion  or  pressure  inwards.  And  fourthly 
a  biting  sensation  is  felt  (sc.  says  Gentile,  if  it  is  a  warm  apostema).  And 
fifthly  the  pain,  says  Gentile,  whether  the  apostema  be  warm  or  cool. 
With  these  (sc.  five)  symptoms  present  then  there  is  an  apostema  out- 
side the  cranium.  Avicenna  on  the  contrary  in  the  same  chapter  says 
among  the  external  apostemata  you  may  distinguish  which  are  warm  and 
which  cool  by  the  touch  and  the  color  and  by  the  congruity  of  that  which 
approaches  it.  And  in  all  these  indeed  one  feels  a  pain  pressing  down 
upon  the  cranium  and  when  you  touch  you  find  the  pain. 

Avicenna  stated  the  prognostic  a  little  before.  [In  the  case  of] 
apostema  on  the  heads  of  infants,  it  should  be  known  whether  its  matter 
be  considerable  and  expelled  violently  from  the  exterior  to  the  interior. 
For  if  it  be  such,  it  may  not  be  cured. 

Cure  it,  says  Avicenna,  by  a  lighter  medicament  in  accordance  with 
the  cure  of  sirsen,  i.e.,  frenzy,  says  Gentile,  and  because  in  the  beginning, 
we  strike  back  those  apostemata,  on  this  account  in  the  beginning  of 
these  apostemata  repercussion  would  be  competent.  But  this  would  be 
doubtful,  since  Avenzoar  entirely  prohibits  repercussion  when  the 
apostema  is  in  the  membrane,  says  Gentile  later  on.  I  believe,  however, 
that  it  would  be  safer  not  to  strike  back  lest  the  matter  creep  toward  the 
cerebrum  or  passages  of  the  throat. 

Some  not  fearing  this  danger  could  strike  back.  Yet  whatever  on  this 
account  may  be  the  local  medicament  which  is  placed  upon  this 
apostema,  it  should  be  lighter  than  that  which  we  use  in  the  cure  of  sirsen 
because  the  medicament  more  immediately  strikes  the  matter. 

If  therefore  the  apostema  be  resolved  under  the  cranium  with 
castoreum,  fenugreek  or  camomile  would  suffice  for  the  resolution 
externally.  But  although  it  be  so,  if  it  be  expedient  to  use  stronger  medi- 
cines, you  can  use  them  more  safely  when  the  apostema  is  external  than 
when  it  is  internal  because  less  is  to  be  feared  from  the  operation  of  strong 
medicine  upon  the  external  part,  since  it  is  more  ignoble,  than  would  be 
upon  the  internal  part,  sc.  the  cerebrum,  since  it  is  the  noble  part.  And 
therefore  when  this  does  not  suffer  apostema  and  is  itself  all  right,  but 
outside  the  cranium  is  an  apostema,  then  we  have  no  fear  from  the  use  of 
strong  medicine  and  this  is  what  Avicenna  says,  so  that  nevertheless  you 
know  you  are  safe  in  the  administration  of  the  stronger  upon  it. 

22  Loc.  cit. 


no  PEDIATRICS  OF  THE  PAST 

Atas,  according  to  Avicenna,23  occurs  in  infants.  Gentile  hereon  says 
atas  is  a  warm  apostema  outside  the  cranium.  The  symptoms  are  swelling 
and  inflation. 

Cure.  Avicenna24  says:  Now  in  atas  of  infants  (i.e.,  in  swelling  or 
inflation  outside  the  cranium,  says  Gentile  it  is  a  warm  apostema 
outside  the  cranium)  provision  should  be  made  that  the  nurse  drink 
barley  water  (says  Gentile,  to  cool  the  nurse's  milk),  or  water  of  savich, 
i.e.  of  barley;  if  the  infant  shall  have  had  a  looseness,  there  should 
also  be  given  to  the  infant  to  drink  a  little  torrefied  spodium  and  torrefied 
seed  of  portulacca,  for  looseness  in  this  disease  is  bad,  says  Gentile, 
because  it  is  feared  that  that  matter  indicates  dysentery  and  the  strength 
of  the  infants  be  dissipated  (dissolvatur),  since  even  they  themselves  are 
subject  to  being  loosened  (resolubiles)  and  are  weakened  (dissolvantur)  by 
wakefulness,  pain  and  fever.  However,  looseness  is  combated  with  water 
of  torrefied  savich  which  is  little  styptic  with  its  coolness  and  therefore 
its  water  when  given  to  the  nurse  thus  disposes  the  milk;  and  other 
things  also  are  to  be  given  to  the  infant  which  are  clear  in  Avi- 
cenna already  mentioned,  because  they  abate  inflammation  and  torre- 
faction  draws  they  stypticit  from  them. 

Lastly  Avicenna  says:  "Upon  their  sinciput  let  a  cooled  violet  rest." 
Says  Gentile,  "He  did  not  demand  styptics  fearing  perhaps  for  the 
strong  repercussion." 

The  third  disease  of  infants  is  water  gathered  in  the  head  of  children.25 

Water  (sc.  sometimes)  occurs  in  the  cerebrum  of  the  infant. 
Avicenna26  says  sometimes  watery  humidities  are  gathered  together 
inside  the  cranium  and  outside  it.  He27  likewise  says:  "Sometimes  there 
occurs  and  properly  to  infants  the  disease  which  is  a  gathering  of  water 
in  the  head,  and  this  disease  is  humidities  retained  between  the  cranium 
and  the  cutis."  Gentile  says  hereon,  i.e.,  in  an  intervening  place  between 
the  os  capitis  and  the  cutis.  Now  this  can  be  in  two  ways.  Either  it  is 
between  the  os  and  the  membrane  and  in  this  case  immediately  affects 
the  os,  or  between  the  cutis  and  the  membrane  and  in  this  case  affects 
the  os  through  the  medium  of  the  membrane.  Avicenna  continues: 
"And  between  the  two  exterior  membranes."  Gentile  hereon  says: 
"Exterior,  sc.  to  the  os,  and  these  are  the  cutis  and  the  membrane." 
But  "between  the  two  membranes"  could  be  understood  otherwise, 
i.e.,  under  the  two,  and  this  because  the  cutis  and  the  membrane  would 
stand  upon  the  water. 

u  Loc.  cit. 

34  Book  in,  loc.  cit. 

24  Avicenna.  Bk.  I,  part  in,  doct.  I,  ch.  iii. 

29  Bk.  in,  part  I,  tractate  3,  ch.  x. 

27  Op.  cit.,  ch.  xi,  and  fen  3. 


CORNELIUS  ROELANS  in 

According  to  Aaron,  as  it  is  laid  down  by  Rasis,28  this  disease  is  an 
inflation  of  the  head  from  aquosity  without  ventosity.  Galen  says,  and 
it  is  laid  down  [by  Rasis]:29  "Sometimes  there  is  water  in  the  head  out- 
side the  cranium  and  it  looks  just  like  a  soft  apostema.  And  sometimes 
it  is  under  the  cranium  and  is  not  apparent  outside  (sc.  to  the  touch). 
But  sometimes  in  both  places  (sc.  inside  and  outside  the  cranium)." 
Niccoli30  hereon  says:  "And,  sc.  when  it  is  inside  the  cranium,  then  it  is 
either  held  under  the  cranium  standing  upon  the  dura  mater  or  between 
the  dura  mater  and  the  pia  mater,  or  it  is  standing  under  the  pia  mater 
upon  the  substance  of  the  cerebrum." 

The  cause  of  this  gathering  of  aquosity  in  the  head  especially  of 
infants  more  than  in  other  membranes  is  sometimes  inside  the  cranium 
and  sometimes  outside  the  cranium.  William  Placentinus  alias  De 
Saliceto,  in  the  beginning  of  his  "Chirurgia,"31  says  the  cause  of  this  is 
twofold.  One  is  the  great  capacity  of  the  head  in  comparison  with  the 
other  external  members.  The  second  is  because  the  infant  in  the  uterus  is 
situated  with  the  head  inclined  and  therefore  to  the  head  flows  the 
watery  humidity  arising  from  the  menstrual  watery  humidity  which 
the  nature  of  the  mother  or  of  the  child  could  not  rectify  but  could  with- 
draw it  into  the  head  [or]  drive  it  there. 

For  on  account  of  these  causes  water  is  gathered  in  the  head  with  the 
aid  of  four  other  general  causes,  laid  down  in  the  beginning  of  this  chap- 
ter by  William,  why  some  member  suffers  an  infirmity  from  an  intrinsic 
cause.  The  first  of  the  causes  is  the  presence  of  matter  or  humor  which  is 
not  suitable  for  conversion  into  nourishment  of  the  members  and  this  is 
either  on  account  of  its  quantity  or  on  account  of  its  malignance.  The 
second  is  the  strength  of  the  member  impelling.  The  third  is  the  weakness 
of  the  member  from  which  the  imfirmity  arises.  The  fourth  is  the  suita- 
bility of  the  passages  for  the  transit  of  humors  from  one  member  to 
another.  It  is  not  in  support  of  the  declaration  of  the  second  principal 
cause,  which  has  to  do  with  the  situation  of  the  infant  in  the  uterus  with 
the  head  inclined  that  William32  lays  down  the  shape  of  the  situation  of 
the  fetus  or  infant  in  the  uterus  saying:  "For  the  fetus  is  bound  to  the 
nurse-mother  and  to  her  loins  and  draws  from  the  veins  of  its  nurse- 
mother  and  the  liver  of  the  woman,  blood  for  nourishment  by  means  of 
the  umbilicus  to  its  liver  on  account  of  the  better  suitability  for  draw- 
ing. And  the  stomach  of  the  infant  and  its  anterior  part  is  located  around 
the  woman's  loins  and  it  holds  its  hands  closed  upon  its  knees  and  with 
head  inclined  upon  its  hands,  its  hands  are  located  in  the  concavities  of 

28  Continens,  bk.  i. 
*  Continens,  bk.  I. 

30  Sermo  in,  tractate  2,  sumraa  4,  ch.  v. 

31  Bk.  i,  ch.  i. 
3a  Loco  dicto. 


ii2  PEDIATRICS  OF  THE  PAST 

the  eyes  of  the  child  and  it  holds  its  nose  between  its  two  hands."  There 
is  apparent  therefore  the  aptitude  of  the  flow  of  matter  toward  the  head 
of  the  fetus  or  infant. 

Gentile,33  however,  on  these  two  causes  of  William,  says,  although 
they  are  apparent,  still  it  is  difficult  for  William  to  assign  the  cause  why 
that  water  does  not  flow  to  the  stomach  of  the  child  since  that  place  is 
more  capacious  and  lower  down  than  is  the  head.  And  although  the  head 
according  to  the  situation  is  extrinsic  with  respect  to  the  concavity  of 
the  stomach,  on  account  of  its  nobility  it  is  intrinsic.  It  must  be  said, 
therefore,  that  the  cause  of  this  water  is  threefold.  The  first  is  the  nature 
of  the  member,  sc.  the  cerebrum,  because  it  is  the  most  humid  and 
watery  member  among  all  the  members  of  our  body  and  especially  in  the 
beginning  of  its  birth.  The  second  cause  is  the  weakness  of  its  covering, 
sc.  the  os,  whence  humidities  could  not  freely  rise  up  and  be  converted 
into  vapor  but  are  retained.  The  third  cause  is  the  passage  to  it  of  vapors 
which,  gathered  together  there  by  its  coolness,  are  converted  into  water.34 

Niccoli35  says  regarding  these  causes:  "These  causes  of  Gentile  seem 
to  be  causes  of  gathering  of  water  rather  inside  the  cranium.  Yet  this 
water  itself  gathered  there  according  to  many  is  expelled  through  joints 
to  outside  the  cranium." 

Avicenna,36  assigning  the  cause  of  the  gathering  and  generation  of 
this  aquosity  or  humidity  above  or  outside  the  cranium,  says:  Sometimes 
there  happens  to  infants  according  to  many  a  gathering  of  aquosity  out- 
side the  cranium  head  when  the  obstetrix  errs  (sc.  says  Niccoli37  in  han- 
dling and  shaping  the  head  of  the  infant)  and  compresses  it  and  separates 
(sc.  by  pressing  it  together  in  its  joints).  Wherefore  there  are  opened 
(sc.  on  account  of  the  compression  and  opening  of  the  joints)  the  orifices 
of  the  veins  and  especially  in  their  pulling  asunder  which  happens  from 
the  separation  of  the  joints  themselves.  And,  says  Avicenna,  it  (sc. 
watery  blood)  runs  to  that  which  is  under  the  cutis.  Niccoli37  says  three 
other  causes  can  be  assigned  for  the  gathering  of  water  outside  the 
cranium  in  children  and  youths.  The  first  is  the  strength  of  the  expulsive 
power  of  the  cerebrum  expelling  the  watery  superfluities  of  the  cerebrum 
to  outside  the  cranium.  The  second  may  be  the  weakness  of  the  conten- 
tive  of  those  veins,  by  reason  of  which  the  aquosity  which: is  in  them 
exudes  with  the  blood  outside  them  to  the  scarlet  fluid  (cocum)  which  is 
between  the  cutis  and  the  cranium.  The  third  cause  may  be  the  multi- 
plication of  watery  nourishments  whose  aquosity  some  of  the  suitable 

33  On  Avicenna,  bk.  in,  part  I,  tractate  3,  ch.  x. 

34  As  is  assumed,  De  partibus  animalium,  bk.  11. 

36  Loco  dicto. 

38  Loco  dicto,  ch.  xi,  canon  3. 

37  Loco  dicto. 


CORNELIUS  ROELANS  113 

causes  attract  to  the  head  and  properly  to  outside  the  head  under  the 
cutis. 

Signa.  Avicenna38  says:  "If  there  are  (sc.  watery  humidities) 
inside  the  cranium  and  their  position  be  upon  the  hard  membrane  (sc. 
dura  mater)  under  the  cranium,  the  sick  person  feels  first  a  heaviness 
within,"  i.e.,  says  Niccoli,  he  ought  to  feel  and  would  show  that  he  feels 
if  an  infant  could  talk.  Secondly  (sc.  the  second  symptom)  is:  "It 
is  accompanied  by  a  difficulty  in  shutting  the  eyes,"  indeed  impossi- 
bility, says  Gentile  thereon,  and  therefore  they  stand  open  gazing  at  one 
place.  The  third  symptom,  says  Avicenna:  "They  water  at  the  eyes  very 
much  and  shed  tears  continually  on  account  of  the  exudation  of  that 
aquosity  toward  them."  Adds  Gentile:39  "And  according  to  many  the 
head  seems  very  large  in  proportion  to  the  neck  and  the  members." 

And  Rases40  is  to  the  same  effect.  The  symptoms  of  that  which  occurs 
under  the  cranium  are:  The  eyes  are  gleaming  and  red  and  weep.  For 
they  bulge  forth  on  account  of  the  great  repletion  and  redden,  says 
Niccoli,  on  account  of  the  warm  vapors  or  on  account  of  the  subtle  and 
warm  parts  of  the  humors  which  flow  to  the  eyes  by  reason  of  the 
pain.  Adds  Rases:  "And  they  have  a  permixture  of  reason  on  account 
of  the  pain."  Says  Niccoli:  "Which  permixture  is  manifested  in  infants 
from  their  various  acts."  Galen  said:  "And  they  spasm  when  the  reple- 
tion has  been  communicated  to  the  nerves  on  account  of  a  great  lesion 
which  is  in  the  source  of  the  nerves,  sc.  the  cerebrum,  and  then  die  when 
they  spasm,  if  the  watery  humidities  have  gathered  upon  the  cranium." 

Avicenna41  lays  down  five  symptoms  of  this.  "First,  an  inflation 
occurs  in  that  place  of  the  head,"  says  Gentile  hereon,  i.e.,  a  depression, 
and  this  either  because  the  os  is  depressed  under  the  matter  or  because  if 
the  matter  is  watery  a  touch  finds  it  with  pressure,  for  it  yields  to  the 
touch.  Another  reading  is  found  in  Avicenna  in  a  certain  text,  as  Niccoli 
says  on  this  symptom.  "A  lowering  occurs  in  a  place  on  the  head,"  i.e., 
when  it  is  pressed  with  the  finger,  it  becomes  furrowed  there  just  as  in 
soft  apostemata.  Says  Galen  on  this  symptom:  "It  seems  like  a  soft 
apostema  to  the  touch." 

The  second  symptom,  says  Avicenna:  "The  infant  happens  to  weep." 
Says  Gentile:  "On  account  of  injury  in  the  little  part."  The  third  symp- 
tom, says  Avicenna.  "Wakefulness  occurs."  Says  Niccoli:  "On  account  of 
lesion  and  tears."  The  fourth  symptom,  says  Avicenna:  "The  unchanged 
color  of  the  cutis."  Hereon  Gentile  and  Niccoli  say  that  water  does  not 
change  the  color  of  the  body  or  member  as  other  humors  do.  The  fifth 

38  Bk.  11,  fen  i,  tractate  3,  ch.  x. 

39  Loco  dicto. 

40  Continens,  bk.  1. 

41  Loco  dicto,  ch.  xi,  canon  3. 


ii4  PEDIATRICS  OF  THE  PAST 

symptom,  says  Avicenna:  "The  cutis  is  raised."  Says  Niccoli:  "The 
head  seems  large  to  the  beholder;  nevertheless  when  it  is  pressed  with 
the  hand  or  finger,  it  is  driven  within,  i.e.,  to  beneath  the  cutis  above 
the  cranium." 

Prognostics.  Avicenna,42  speaking  of  water  inside  the  cranium  says 
for  this  kind  there  is  no  natural  disposition.  Haliabas43  says  the  same. 
And  the  cause  of  this,  says  Gentile  hereon,  is  that  much  malignance  in 
the  cerebrum  is  signified.  Yet  some  relate  that  they  have  seen  persons 
cured  with  cautery  reaching  even  to  part  of  the  os  and  not  perforating  it 
entirely  and  with  resolving  medicines.  The  compiler  of  the  work  [says] : 
"  But  still  it  does  not  seem  that  it  should  be  tried  in  the  case  of  a  child." 

Avicenna44  also  says  you  should  learn  whether  there  is  much  water 
or  it  is  expelled  violently  from  the  exterior  to  the  interior  places.  For  if  it 
shall  have  been  so,  it  is  not  curable,  says  Gentile  (sc.  as  for  the  most 
part),  because  much  malignance  in  the  cerebrum  is  signified. 

Cure.  Niccoli45  says:  "It  is  curable,  i.e.,  if  the  water  be  scant,  and 
held  between  the  cutis,"  says  Avicenna,46  and  the  cranium.  That  which 
is  called  curable  is  accomplished  by  the  threefold  instrument,  sc.  diet, 
potion  and  surgery.  The  first  instrument,  sc.  diet,  is  fulfilled  by  adminis- 
tering to  the  nurse  a  diet  similar  to  the  diet  for  a  bad  humid  complexion 
of  the  cerebrum.  The  nurse,  therefore,  avoiding  humectic  foods,  should 
live  in  a  dry  climate,  dry  abode  swept  by  the  north,  i.e.,  boreal,  winds,  in 
which  the  fire  of  dry  wood  is  burned,  should  use  thought,  care  and  many 
vigils,  motion  also,  rubbings,  combing  of  the  head,  drying  baths  and 
should  feed  on  drying  foods  in  dry  form,  roasted  or  fried,  should  diminish 
drinking  as  much  as  possible  and  use  fasting  and  evacuation  of 
superfluities. 

The  second  instrument  is  potion.  The  regimen  of  potion  is 
accomplished  for  three  intentions.  The  first  is  for  evacuation.  The  second 
for  resolving.  The  third  for  strengthening  the  cerebrum,  lest  the  matter 
be  generated  anew.  The  first  intention  which  is  that  of  evacuation  is 
fulfilled  by  evacuating  the  nurse  with  many  evacuations,  with  medicines 
which  draw  out  the  phlegm  and  aquosity  especially  from  the  head. 
Yet  the  compiler  [says  it  is  fulfilled]  by  always  having  in  mind  the  canon 
of  Hippocrates,47  that  digested  foods  cure  and  move  those  not  undigested, 
i.e.,  by  always  administering  between  evacuation  and  evacuation  reme- 
dies digestive  of  those  humors,  which  knowledge  I  leave  to  the 
practitioners. 

42  Loco  dicto,  ch.  x,  can.  3. 

43  Practica,  bk.  ix. 

44  Ch.  ix  f. 
46  Loco  dicto. 

46  Loco  dicto. 

47  Aphorisms,  1,  22. 


CORNELIUS  ROELANS  115 

After  many  complete  evacuations  (sc.  if  need  be)  and  the  matter  is 
well  diminished,  one  must  come  down  to  the  particular  evacuation,  sc. 
sneeze-provocatives  (sternutatoria)  through  plasters,  through  gargles  or 
head  purges.  A  good  sneeze-provocative,  says  Alkindus  and  it  is  laid 
down  [by  Rases]48  is : 

1$  fellis  gruis,  fellis  vulturis,  castorei,  fustium 

rutae  silvestris,  macis  et  croci ana  partes 

aequales 

sacchari  albi duas  pertias 

unius  partis 

Let  them  be  ground  very  fine  and  made 
into  a  paste  with  the  juice  of  psyllium 
viridis  and  grains  be  molded  from  these 
lentils  and  dried  in  the  shade  and  one  grain 
dissolved  in  rose  water  every  day  and 
dropped  for  three  days  in  the  nostrils  in  the 
morning. 

And  let  the  head  be  measured  with  a  thread  from  the  first  day  of 
the  waning  of  the  moon  and  seek  the  first  day  of  its  newness  and  it  will 
be  found  diminished  from  its  inflation.  And  afterwards  a  distillation  is 
begun  in  the  aforesaid  manner  and  the  swelling  will  cease  entirely. 
For  this  is  a  good  sneeze-provocative  and  approved  for  introducing  in 
the  nostrils  of  the  infant  whose  head  is  swelled  with  water. 

Plaster  or  epithem,  of  Rases:49 

1$  Nasturtium  seeds  and  mix  and  shake  with  water  and 
make  a  paste  therefrom  and  apply  to  head  as  plaster. 

Gargle  of  Peter  de  Cussiniana: 

Ifc  Bethonicae,  hyssopi  ana  manipulum  semis 
glycyrrhizae,  rasae,  passularum 

mandatarum  ab  arillis  ana  5  M 

piretri,  ireos  recentis  ana  5  H 

seminis  saxifragae,  zingiberis  ana  5  x 

masticis  5  H 

mellis  5 1 

aquae  communis  lb.  ii 

Let  them  be  boiled  one  third 
away.  Administer  twice,  morn- 
ing and  evening. 

48  Continens,  i. 

49  Continens,  i. 


u6  PEDIATRICS  OF  THE  PAST 

Head  purge  of  the  same: 

1$  Aquae  majoranae  lb.  i 

aceti  squillitici  3  iii 

pulveris    origani,    piretri,    masticis,    piperis, 
sinapis  ana  3  % 

For  this  is  sufficient  perhaps. 

The  second  intention,  which  is  for  resolving,  is  fulfilled  with  resolving 
and  drying  anointings,  poultices  and  plasters  placed  upon  the  head  with 
which  should  be  mixed  a  species  of  cerebral  aromatics;  says  Niccoli: 
"Among  which  is  the  following  plaster: 

1$  origani,    calamenti,    savinae,    scicados, 

serpilli,  gallarum,  cipressi  ana  3  u 

cinnamoni,  nucismuscatae  corticum,  citri, 
macis  ana  3  i 

cerae  5  "i 

olei  de  Iilio,  olei  de  costo  5  }$ 

succi  sansuci  {i.e.  majoranae)  5  i>£ 

Let  a  plaster  be  made  from  these." 

Avicenna50  says:  "If  the  water  has  been  very  scant,  then  it  is 
sufficient  for  you  that  the  watery  humor  be  resolved  with  plasters." 
Says  Gentile:  "Sc.  warm,  resolving  and  drying,  as  from  sulphur,  aris- 
tologia,  farina  Iupinorum  and  the  like." 

The  third  intention,  which  is  for  strengthening  the  cerebrum  lest  it 
generate  the  matter  anew,  is  fulfilled  with  good  odoraments  drying  and 
warming  the  cerebrum,  as  musk,  marjoram,  rue,  etc.,  and  with  the  use  of 
electuaries  doing  this,  as  pliris.  arcoticon  nicbolai  acori  conditi  theriac, 
mithridate  (sc.  after  evacuations). 

Mesue61  offers  a  good  odorament: 

1$  Castorei,  rutae  siccae  ana 

Let   a   ball   be   made   with   gum-tragacanth  and 
odorated. 

Likewise  species  odorate  per  se  fulfill  this  intention. 

The  third  instrument  is  cure  by  surgery.  Avicenna62  says:  "If  the 
water  has  been  scant  and  retained  between  the  cutis  and  the  cranium, 
then  make  one  incision  widthwise,  or  if  it  has  been  much,  make  two 
incisions  intersecting  each  other  or  three  incisions  intersecting  each  other, 
if  there  have  been  very  many;  and  let  what  is  in  it  be  evacuated."  Says 

50  Loco  dicto,  sc.  ch.  xi. 

61  Appropriatae,  II,  part  i,  sect,  i,  ch.  iii. 

*2Loco  dicto,  sc.  bk.  m,  tractate  3,  ch.  xi. 


CORNELIUS  ROELANS  117 

Niccoli:53  "Sc.  if  it  is  scant,  let  it  all  be  evacuated  at  one  time.  But  if 
much,  then  in  two  or  more  times."  "Then,"  says  Avicenna,  "after  the 
water  has  been  extracted,  bind  and  place  wine  and  oil  on  the  incisions 
which  you  have  made."  Says  Niccoli:  "Because  wine  dries,  oil  prevents 
solidifying  and  both  mixed  lessen  the  pain;  and  follow  this  procedure  for 
three  days."  Afterwards  loose  the  bindings  and  cure  with  ointments  and 
lints,  if  they  need  them,  and  with  a  thread  (i.e.  threads)  of  cloths  (sc. 
linen  cloth)  for  drying  and  with  powders  (sc.  drying,  abstersive  and 
resolving,  and  in  fine  incarnative  and  consolidating).  And  if  you  can 
cure  with  these,  don't  use  ointments.  "But  if,"  says  Niccoli, 
"linen  thread  and  powder  is  not  sufficient  for  you,  cure  with  ointment 
and  lints  capable  of  fulfilling  the  intentions."  Avicenna  subjoins:  "And 
if  the  generation  of  flesh  is  slow,  it  is  directed  (sc.  by  the  authorities) 
that  the  os  be  lightly  shaved  so  that  the  malignance  be  removed  there- 
from and  flesh  be  regenerated  thereon." 

The  compiler:  "These  sneeze-provocatives,  gargles,  or  head  purges 
must  be  used  only  in  a  very  strong  child,  nay  rather  in  the  nurse  and  it  is 
the  ordinary  method  of  veterinary  practitioners." 

The  fourth  disease  of  children  is  wind  or  inflation  of  the  head  of 
children,  and  it  is  called,  according  to  Jacques  Despars,  atas  or  atasus 
in  Arabic,  i.e.,  wind  of  infants  filling  and  distending  their  heads.  But, 
according  to  Gentile,  atas  is  a  warm  apostema  outside  the  cranium  with 
swelling  and  inflation.  Niccoli  of  Florence:54  "Inflation  of  the  head  is 
two-fold;  one  is  windy,  the  other  is  watery."  Aaron  says,  as  is  laid  down 
[by  Rases55]:  "The  head  is  enlarged  and  inflated  sometimes  from  the 
ventosity  of  the  gross  humidity  existing  in  the  same  place,  which  (sc. 
gross  humidity)  is  filled  with  wind  and  extends  and  inflates  (sc.  and 
sometimes  is  inflated  from  aquosity  without  ventosity)."  The  compiler, 
having  already  spoken  of  watery  inflation  in  the  third  species  of 
children's  diseases  mentioned  above,  passes  it  by  here. 

On  watery  inflation  and  ventosity  of  gross  humidity  or  on  wind  of 
infants  filling  and  distending  their  heads  which  is  called  atas  or  atasus  in 
Arabic  by  Jacques  Despars.56  Now  the  discourse  is  about  atas  or  atasus 
in  so  far  as  it  is  a  warm  apostema  outside  the  cranium  with  inflation  and 
swelling,  just  as  Gentile57  explains  it.  I  have  already  discoursed  on  the 
second  species  of  children's  diseases.  And  let  this  be  sufficient  concerning 
the  specification  of  the  chapter  and  its  difference. 

55  Loco  dicto. 

54  Sermo  in,  tractate  2,  summa  4,  ch.  v. 

55  Continens,  1. 

56  Canon  1,  fen  3,  doct.  1,  ch.  iii  in  explanation  of  part  30  of  the  chapter. 
67  On  Avicenna,  bk.  m,  fen  i,  tractate  3,  ch.  xi. 


n8  PEDIATRICS  OF  THE  PAST 

Avicenna68  says:  "Wind  happens  to  an  infant."  The  faithful  inter- 
preter of  Avicenna,  Jacques  Despars,  hereon  says:  "The  wind  of  infants 
filling  and  distending  their  heads  sometimes  happens  to  infants."  After- 
wards he  says:  "Windy  inflation  of  the  head  of  infants  commonly  arises 
from  their  heat,  cloaked  and  calmed  under  many  gross  and  viscous 
humidities  which,  since  it  cannot  overcome  and  is  strong  enough  not  to 
be  extinguished,  operates  against  them  by  a  weak  and  imperfect  opera- 
tion, filling  them  with  wind  and  making  them  bubble  up,  just  as  the  heat 
of  the  stomach  operates  against  foods  by  which  it  cannot  entirely  be 
dominated.  And  this  is  the  disease  which  in  Arabic  is  called  atas 
or  atasus."  Gentile59  moreover  says  atas  is  a  swelling  of  infants  which 
appears  on  their  heads.  Afterwards  the  same  authority  says  through  two 
columns  [that]  atas  is  a  warm  apostema  outside  the  cranium  and  is  a 
swelling  or  inflation  of  the  head. 

Note  from  this  paragraph  that  this  slight  equivocation  of  the  term 
atas  indicates  no  or  little  difference.  I,  the  compiler,  take  as  one,  atas 
in  so  far  as  it  is  a  warm  apostema  outside  the  cranium  of  children  arising 
just  as  Gentile60  explained  it  and  as  I  have  treated  it  in  the  second  disease 
of  children ;  and  atas  or  atasus  in  so  far  as  it  is  the  wind  of  infants  filling 
and  distending  their  heads,  as  Jacques  Despars61  explained  it  and  as  I 
take  it  in  this  second  species  of  children's  diseases. 

But  the  fact  that  atas  as  being  an  apostema  outside  the  cranium  and 
as  being  the  wind  of  infants,  is  taken  as  one,  it  seems  can  be  elicited 
from  the  words  of  Gentile  speaking  thus  upon  the  word  of  Avicenna  :62 
"Now  which  of  the  external  apostemata  are  warm,"  etc.,  because  there 
he  lays  down  a  cure  for  apostemata  occurring  in  infants  outside  the 
cranium,  sc.  which  were  treated  before  in  the  second  disease  of  children 
and  by  Jacques  Despars  on  Avicenna.63  And  from  the  words  of  Gentile 
speaking  up  on  Avicenna  64  on  the  words  "In  atasum  autem  infantium," 
etc.,  because  there  he  lays  down  in  particular  a  cure  of  atas,  i.e.  of  swelling 
or  inflation,  and  it  is  warm  apostema  outside  the  cranium.  Note  this  is 
clear  from  the  last  statement  of  Gentile  that  a  swelling  or  inflation  which 
is  the  same  as  wind  of  infants,  concerning  which  Jacques  Despars,65  and  a 
warm  apostema  outside  the  cranium  are  the  same.  And  if  they  differ,  it  is 
little,  because  if  they  differ  then  it  can  be  that  I  speak  in  the  second  disease 
of  children  of  atas  in  general,  but  here  in  the  fourth  of  atas  in  particular 

88  Canon  I,  fen  3,  doct.  1,  ch.  iii. 

69  On  Avicenna,  bk.  in,  fen  i,  tractate  3,  ch.  xi. 

60  Loco  dicto. 

ei  Canon  1,  loco  dicto. 

"  Bk.  in,  fen  1,  tractate  3,  ch.  xi. 

68  Bk.  1,  fen  in,  doct.  1,  ch.  iii,  in  the  thirtieth  part  of  the  chapter. 

«4  Bk.  hi,  fen  1,  tractate  3,  ch.  xi. 

*6  Bk.  1,  fen  in,  doct.  1,  ch.  iii,  thirtieth  part  thereof. 


CORNELIUS  ROELANS  119 

But  that  they  can  be  taken  as  one  could  be  elicited  from  Avicenna 
also  because  what66  are  explained  in  different  places  or  (sc.  by  the  faith- 
ful interpreter  of  Avicenna,  Jacques  Despars)  in  the  same  parts  are 
treated  by  Avicenna.67  Since  therefore  they  seem  to  be  in  agreement  and 
in  the  truth  of  the  matter  are  in  agreement,  I  shall  not  be  blamed,  I  beg, 
because  I  borrow  the  symptoms  and  cure  laid  down  in  the  second  disease 
of  children  for  appropriation  here  in  the  fourth  disease  and  take  them  up 
again  as  usefully  as  I  can  in  order  that  they  may  cling  better  in  the 
memory. 

Atas  or  atasus,  as  is  elicited  from  what  has  been  said  above,  could  be 
thus  described :  It  is  a  warm  apostema  or  windy  inflation  of  the  head  of 
infants  proceeding  from  their  weak  heat,  cloaked  and  calmed  under 
many  gross  and  viscous  humidities  which,  since  it  cannot  overcome  and  is 
strong  in  its  root,  operates  against  them  by  a  weak  operation  by  filling 
them  with  wind  and  making  them  bubble  up.  Its  cause  is  clear  from  this 
description. 

The  general  symptoms  may  be  swelling  and  inflation.  The  special 
symptoms  of  atas  may  be  those  five  laid  down  by  Avicenna68  and  also  laid 
down  above  in  the  second  disease  of  children.  1.  The  color  of  the  cutis  is 
changed  from  its  natural  color.  2.  The  touch  is  different  because,  says 
Gentile  hereon,  in  a  warm  apostema  it  is  warm  and  in  a  cool  apostema  it 
is  cool,  or  different,  sc.  from  the  touch  of  water.  3.  There  is  there  a 
strength.  Gentile  says,  there,  sc.  on  the  place;  strength,  i.e.,  resistance 
and  prevention  as  regards  expelling.  He  intends  to  say  that  the  apostema 
resists  the  touch.  4.  A  biting  sensation  is  felt,  if  it  is  a  warm  apostema, 
says  Gentile.  5.  There  is  pain,  there,  whether  the  apostema  be  warm  or 
cool.  Avicenna69  also  seems  to  say  the  same  symptoms  must  be  found. 

Now  which  of  the  external  apostemata  are  warm  and  which  cool 
you  will  discover  by  the  touch  (sc.  warm  or  cool)  or  otherwise  by  the 
(sc.  different)  color  (sc.  of  the  body)  changed  from  its  natural  color  and 
by  the  appropriateness  of  that  which  approaches  it,  says  Gentile,  sc.  of 
things  which  help  or  harm.  And  in  all  indeed  there  is  felt  a  pain  pressing 
down  upon  the  cranium,  sc.  as  if  something  were  pressing  upon  the 
cranium.  And  when  you  touch,  you  find  the  pain,  i.e.,  which  it  is  touched, 
it  pains.  For  these  symptoms  seem  to  coincide  with  the  symptoms  just 
given  and  neither  Avicenna  nor  Jacques  Despars  70  offer  others.  There- 
fore I  hope  I  have  not  made  a  mistake. 

66  In  primo  canone,  loco  dicto,  ch.  iii,  in  the  13th  part  and  in  the  thirtieth  part  of 
that  chapter. 

67  Bk.  in,  fen  1,  tractate  3,  ch.  xi,  third  canon  in  the  chapter. 

68  Ch.  xi,  third  canon  cited  above. 

69  Bk.  in,  same  ch.  xi. 

70  On  Bk.  1,  fen  3,  doct.  1,  ch.  iii,  30th  part  thereof. 


120  PEDIATRICS  OF  THE  PAST 

Cure.  Avicenna71  says:  "In  atas  or  atasus  of  infants  the  nurse 
should  drink  barley  water  (says  Gentile,  sc.  to  cool  the  nurse's  milk)  or 
(says  Avicenna)  savich  of  barley."  Jacques  Despars  hereon  says:  "By 
savich  of  barley  understand  barley  which,  before  it  is  hardened  by  full 
maturity,  is  lightly  torrefied  in  an  earthen  or  brass  vase  over  a  fire, 
then  ground  up  it  is  ventilated  until  the  entire  hull  comes  off,  then  it  is 
broken  in  two,  for  thus  the  oriental  experts  call  savich,  as  Jannensus 
relates  that  he  has  heard  from  them."  Avicenna  continues,  saying: 
"If  the  infant  shall  have  had  looseness,  give  him  a  little  torrefied  spodium 
and  torrefied  seed  of  portulacca  to  drink."  Gentile  hereon  says:  "Now 
looseness  (sc.  of  the  bowels)  is  combated  with  water  of  savich,  i.e.,  of 
torrefied  barley  which  is  little  styptic  with  its  coolness  and  therefore  its 
own  water  when  given  to  the  nurse  thus  disposes  the  milk.  And  give  also 
for  this  intention  spodium  and  seed  of  portulacca,  because  these  abate 
the  inflation  and  their  torrefaction  acquires  stypticity  from  them." 
"Looseness  (sc.  of  the  bowels),"  says  Avicenna,  "in  this  disease  is  bad"; 
says  Gentile,  "because  it  is  feared  that  that  matter  might  induce  dysen- 
tery and  the  strength  of  the  infants  be  dissipated,  since  they  too  are 
subject  to  being  loosened  and  are  weakened  by  wakefulness,  pain  and 
fever."  Says  Avicenna:  "Let  the  nursling  be  introduced  into  a  bath  (sc. 
lest  it  inflame  it)  and  let  there  be  placed  upon  its  head  a  cooled  violet 
(sc.  to  keep  the  matter  from  the  inflammation)."  Gentile  says:  "He 
(sc.  Avicenna)  did  not  demand  styptics  fearing  perhaps  for  the  strong 
repercussion." 

Avicenna72  also  offers  a  medicine  extremely  beneficial  in  wind  of 
infants,  such  as  give  in  a  potion  to  the  infant  a  weight  of  three  grains  of 
barley  of  powder  made  from  dry  origan  and  castoreum  and  cumin  mixed 
equally  and  finely  ground.  Jacques  Despars  adds:  "And  it  may  be 
given  with  milk  or  with  water  of  honey.  For  the  said  powder  is  strongly 
carminative  and  resolves  ventosities  whether  they  have  been  in  the 
stomach  or  in  the  head  or  in  the  intestines." 

Note  here  the  doubt  of  Jacques  Despars  to  the  following  effect.  But 
it  is  worthy  of  admiration  that  the  eminent  Avicenna  here  in  wind  of 
infants  employs  medicines  of  vigorous  warmth,  as  castoreum,  cumin  and 
origan,  and73  in  atas  of  infants  recommends  cool  medicines  both  inside 
and  outside,  as  water  of  barley  and  its  savich  and  spodium  and  seed  of 
portulacca  and  also  violet  placed  upon  the  head  which  in  no  wise  seem  to 
be  competent  in  inflation.  Nor  does  Rases,  the  highest  and  greatest 
practitioner  in  the  cure  of  diseases,  recommend  cool  medicines  in  this 

71  Ch.  xi,  iii  canone  iam  dicto. 

72  Primo  tenia,  doctrina  prima,  capitulo  tertio,  in  tricesima  parte  eius.  [Bk.  i,  fen 
in,  doct.  i,  ch.  iii,  is  the  thirtieth  part  thereof.] 

73  Bk.  in,  fen  i,  tractate  3,  ch.  xi. 


CORNELIUS  ROELANS  121 

case  but  many  warm  ones,  as  oil  of  bitter  almonds,  oil  of  ben  and  water 
of  marjoram  gently  introduced  in  the  infant's  nostrils  and  a  plaster 
of  oliban,  sarcocolla,  serapinum  of  gum  of  almonds  placed  upon  the 
head  and  ointment  of  area  nucum  and  smeared  upon  the  head  with  a 
little  oliban  and  wolf's  gall  and  a  little  amber  or  myrrh  introduced 
in  the  nostrils,  just  as  is  maintained  in  the  fifth  species  of  diseases 
of  children. 

For  answer,  note  that  ventosity  is  twofold.  One  is  vaporable  from  the 
weak  heat  ventilating  the  humidity.  The  other  is  smoky,  turbid,  which 
a  vigorous  heat  generates  operating  against  the  humidity.  And  in  the 
extermination  of  the  former,  warm  medicines  are  beneficial,  and  in  the 
extermination  of  the  latter,  cool  medicines. 

The  fifth  disease  of  children  is  largeness  of  the  head  of  children. 
Jacques  Despars74  says:  "Sometimes  the  infant  is  born  with  a  head  so 
large  that  the  trunk  of  the  body  scarcely  supports  it."  Rases75  says: 
"It  happens  to  some  children  that  they  issue  forth  with  a  large  head  and 
after  birth  it  is  enlarged  beyond  due  measure  and  I  have  seen  a  child 
whose  head  was  enlarged  in  length  so  that  its  body  could  not  support  it 
and  it  did  not  cease  being  enlarged  until  the  child  died."  Now  the  large- 
ness of  head  will  arise  either  from  gross  ventosity  generated  in  the  bones 
of  the  head  or  from  gathering  of  water  enclosed  therein  which  did  not 
find  a  way  of  egress  therein. 

Cure.  The  compiler  [says  that]  the  cure  of  it  when  it  arises  from 
gathering  of  water  is  to  be  had  in  the  third  disease  preceding;  the  cure  of 
it  when  it  arises  from  gross  ventosity  generated  in  the  bones  of  the  head 
is  to  be  had  in  the  fourth  disease  preceding.  Rases76  thus  describes  the 
cure  of  largeness  or  enlargement  of  the  head  arising  from  aquosity  and 
ventosity:  "Begin  in  the  cure  of  it  by  purging  the  head  of  the  nurse  with 
the  large  iris  and  let  her  avoid  all  foods  generating  ventosity  and  gross 
superfluities.  Then  begin  in  its  cure  with  those  things  which  are  intro- 
duced in  the  nostrils  of  children,  as  oil  of  bitter  almonds  or  oil  of  dill  or 
best  oil  of  ben  or  water  of  marjoram  and  if  it  is  cured  in  this  way,  it  is  suffi- 
cient. But  if  not,  place  upon  the  head  a  plaster  of  oliban,  sarcocolla, 
serapinum  of  gum  of  almonds;  if  he  shall  have  been  cured,  it  is 
sufficient.  But  if  not,  take  area  nucum  and  pound  with  its  shells  until  it 
becomes  like  an  ointment.  Mix  with  it  a  little  oliban  and  place  upon 
the  entire  head  after  shaving  and  leave  for  a  few  days.  These  medicines 
contract  the  head  and  cause  it  to  return  to  due  size.  Then  place  in  its 
nostrils  wolfs  gall  or  cerebrum  and  a  little  myrrh  or  amber  and  do  this  in 
any  month."  This  from  Rases. 

74  On  Avicenna,  bk.  i,  fen  ill,  doct.  i,  ch.  iii,  in  the  thirteenth  part  thereof. 

75  Book  of  children's  diseases,  ch.  iii,  and  Book  of  experiments,  ch.  xxii. 

76  Libro  dicto. 


i22  PEDIATRICS  OF  THE  PAST 

The  sixth  disease  of  children  is  saphati  of  children.  Rases:77  "Saphati 
is  sometimes  called  impetigo  of  the  head  and  by  some  is  called  tinea  and 
among  the  laity  is  called  milk  crust  (lacticium)  either  because  it  happens 
for  the  most  part  to  nurslings  or  because  it  happens  to  them  on  account 
of  the  milk's  sharpness  inducing  saltiness  in  their  nourishment,  whence 
the  material  of  nourishment  is  rendered  putrid  and  viscous."  "  Impet- 
igo," as  Papias78  says,  "is  a  dry  scabies  arising  with  a  roughness  and 
having  a  round  shape."  Huguccio  says  the  same.  Avicenna79  says: 
"Saphati  arises  from  a  number  of  ulcerous  globules  and  indeed  saphati 
in  the  beginning  is  small  globules."  Niccoli80  hereon  says:  "Small  globules 
such  as  ants  seem  like."  Then  says  Avicenna:  "Lightly  fastened  and 
scattered  in  many  places."  Says  Niccoli.  "Because  they  are  many  and  of 
multiplying  number."  Then  Avicenna:  "Are  ulcerated  with  crusty 
ulcers."  Niccoli  says  then:  "i.e.,  after  the  process  and  in  the  process 
they  are  ulcerated  on  account  of  the  sharpness  of  the  matter  and  crusts 
form  thereon  on  account  of  the  dryness  and  viscosity  of  the  matter." 
Avicenna:  "And  they  are  prone  to  redness."  Niccoli:  "Because  some 
portion  of  choleric  blood  is  drawn  to  the  place."  Jacques  Despars81 
says:  "On  the  authority  of  Rases82  saphati,  i.e.,  red  spots  which  are 
formed  with  small  pustules,  happens  to  children  and  perhaps  happens 
on  the  face  and  on  the  head."  Peter  de  Argellata83  says:  "Saphati  is  a 
certain  redness  in  the  cutis  of  the  head  in  which  redness  arise  pustules 
scattered  in  a  number  of  places  and  are  broken  and  then  the  place  is 
ulcerated  and  often  they  go  away  and  sometimes  return  and  this  is  due 
only  to  the  bad  complexion  of  the  cutis."  Avenzoar  says:  "Saphati  is  a 
disease  of  redness  which  happens  in  the  flesh  and  this  redness  is  of  the 
color  of  the  lung.  Yet  it  is  various  and  different  according  to  the  tenseness 
and  looseness  within  the  diversity  of  the  matter  causing  it."  Niccoli84 
says:  "Some  say  that  tinea  particularly  is  saphati.  For  it  is  a  defiling  of 
the  cutis  with  crust  as  with  heavy  phlegm,  with  falling  of  the  hairs  or 
thinning  of  them  when  it  occurs  on  the  head." 

Avicenna84  divides  saphati  into  two  species,  sc.  the  moist  and  the  dry, 
speaking  as  follows:  "Saphati  sometimes  emits  a  poison  and  is  called 
serengi  or  moist  saphati  and  sometimes  dry  scales  begin  (says  Niccoli: 
'and  they  do  not  emit  poison')  and  it  is  called  dry  saphati." 

"Continens,  xxv. 

78  S.  v.  peto. 

79  Bk.  iv,  fen  vn,  tractate  I,  ch.  i. 

80  Sermo  vn,  tractate  6,  ch.  xx. 

*l  On  Avicenna,  bk.  i,  fen  in,  doct.  I,  ch.  iii,  in  the  last  part  of  the  chapter. 

82  Children's  diseases,  ch.  i. 

83  Chirurgiae,  bk.  v,  tractate  3,  ch.  iii. 
**Loco  dicto. 


CORNELIUS  ROELANS  123 

Galen  concerning  moist  saphati  proposed  three  species.  In  the  Miamir 
he  touched  upon  the  first  two  especially  and  the  first  he  called  acarus  and 
is  tinea  of  the  cutis  of  the  head  perforated  with  fine  foramina  and  emit- 
ting a  certain  subtle  humidity  with  slight  viscosity.  The  second  is  like  the 
foregoing  but  its  foramina  are  larger  and  broader,  emitting  a  humidity 
like  favosity  of  honey.  And  the  third  is  between  the  foregoing  holding  a 
middle  position,  which  he  touched  upon  in  the  book  on  apostemata,  and 
has  foramina,  not  so  fine  as  the  first  species  nor  so  broad  as  the  second, 
from  which  flows  a  favosity  not  subtle  as  water  nor  gross  as  the  honey 
flowing  from  a  favose  ulcer. 

Haliabas86  proposes  clearly  six  species.  Namely  the  first  favose  from 
which  a  humidity  similar  to  favosity  of  honey  exudes.  The  second  is 
ficous  in  which  is  contained  something  similar  to  grains  of  figs,  i.e., 
round  hard  things  in  which  there  is  redness.  The  third  is  aqueous  from 
which  exudes  a  humidity  of  water  similar  to  flesh  through  smaller  fora- 
mina than  those  which  are  in  the  favose  kind.  The  fourth  is  ulcerous  like 
the  nipples  of  the  breasts  of  women  with  redness  from  which  a  humor 
flows  similar  to  blood.  The  fifth  is  Iupinous,  similar  in  color  and  shape 
to  lupines  from  which  as  it  were  shells  of  scales  flow  white  and  dry.  And 
under  this  head  he  includes  the  sixth  which  is  called  furfurous,  from 
which  flow  subtle  bodies  according  to  many  similar  to  bran  (furfur) 
among  which  are  sometimes  certain  bodies  a  little  more  gross. 

Niccoli86  says:  "There  is  also  a  certain  species  of  dry  saphati  which  in 
our  idiom  is  called  rutiola  or  ruffola  occurring  much  in  children  while 
they  are  nursing." 

Cause.  William  Placentinus87  says:  "Saphati  is  sometimes  with 
moist  pustules,  sometimes  with  dry  pustules,  and  both  may  be  recent 
or  old.  The  first,  sc.  with  moist  pustules,  always  occurs  from  salty  phlegm 
in  which  the  heating  has  not  yet  arrived  or  from  blood  in  a  certain 
manner  mixed  with  cholera.  The  second,  sc.  which  occurs  from  dry  pus- 
tules, occurs  from  phlegm  which  the  heating  has  terminated  or  from 
blood  mixed  with  cholera  by  whose  humidity  the  heating  is  finished." 

Rases88  says:  "Saphati  is  a  generation  on  account  of  the  quantity  of 
blood  and  the  humidity  of  the  cutis."  Niccoli89  says:  "Some  causes  are 
intrinsic  and  some  extrinsic.  The  intrinsic  are  malignant,  salty,  nitrous, 
sharp  and  corrosive  humors,  sometimes  subtle,  sometimes  gross  and  as 
generally  happens  mixed  of  the  two,  which  sometimes  cause  this  gener- 
ation in  the  uterus  before  birth  and  sometimes  are  generated  after  birth 
because  of  the  faultiness  of  the  other's  regimen." 

M  Tbeoretica,  vin. 

86  Loco  dicto. 

87  Practica,  bk.  Ill,  ch.  viii. 
**  Children's  diseases,  ch.  L 
89  Loco  iam  dicto. 


i24  PEDIATRICS  OF  THE  PAST 

Avicenna90  says:  "The  cause  is  a  malignant,  sharp,  corrosive 
humidity,  which  is  mixed  with  blood.  And  the  gross  malignant  humors 
(sc.  through  the  heating  of  the  said  corrosive  humidity)  are  also  a  cause 
why  the  gross  is  an  apostema  and  the  subtle  is  dried."  "He  understood," 
says  Niccoli,89  "that  those  gross,  malignant  humors,  which  are  contained 
in  the  cutis  of  the  head,  make  thereon  an  apostema  and  gross  globule 
whose  subtle  is  dried,  i.e.,  the  subtle  poison  is  emitted  outside." 

And  those  humors  are  the  cause  of  species  of  moist  saphati,  and  yet 
in  the  first  of  its  species  the  humors  are  more  subtle  and  sharp  and  in 
the  second  more  gross  and  less  sharp  and  in  the  third  they  are  in  between. 
But  the  cause  of  dry  saphati  is  a  melancholy,  dry,  malignant  humor 
mixed  with  a  choleric,  sharp  humidity  which  causes  it  to  be  expelled  to 
the  cutis  and  bursts  through  and  corrodes  with  gross  crusts.  And  these 
humors,  when  they  are  long  in  the  body  or  head  outside  the  cutis,  hold 
the  place  of  the  antecedent  cause,  and  when  they  are  in  the  cutis  actually 
causing  the  disease,  they  hold  the  place  of  the  conjoint  cause.  The 
extrinsic  causes  are  a  bad  regimen  in  the  six  things  not  natural,  especially 
in  food  and  drink. 

"The  symptoms  of  the  genus  and  even  of  the  first  species,"  says 
Niccoli,  "are  known  from  what  has  been  said  and  are  to  be  had  through 
sight  and  the  report  of  the  sick  person.  And  with  this  also  does  moist 
saphati  begin,  with  a  biting  itch  compelling  one  to  scratch;  afterwards 
the  place  begins  to  swell  and  is  enlarged  and  filled  with  foramina  from 
which  a  poison  emerges  and  according  to  many  a  crowd  of  lice  follow 
thereupon.  And  sometimes  under  its  gross  crusts  worms  are  generated 
and  when  it  advances,  an  offensive  smell  is  perceived  from  the  place." 

Rases91  says:  "Its  symptom  is  small  wounds  from  which  a  humor 
comes  forth  which  is  expanded  on  the  head  and  on  the  face  and  is  accom- 
panied by  an  itching  which  keeps  the  child  awake  and  wailing  and 
fretting." 

"The  symptoms,"  says  Niccoli,  "of  the  matter  are  known  from 
what  has  been  said.  For  if  it  shall  have  been  bloody,  there  will  be  a  more 
obscure  redness  in  the  place  and  inflaming  heat  and  pain  and  slight 
itching  and  slight  flow  of  poison.  More  color  signifies  poison  flowing  upon 
the  matter  and  confirmation  of  this  knowledge  [comes]  through  reflec- 
tion upon  the  past  regimen  and  other  particulars.  And  the  color  in  dry 
saphati  declines  to  yellowness,  greenness  and  blackness  from  which  noth- 
ing is  emitted  or  something  not  very  subtle  after  the  manner  of  urine." 

William92  says:  "The  symptoms  of  the  first  species  (sc.  afore- 
mentioned), sc.  the  moist,  are:  on  the  head  or  on  the  face  there  appear 

10  Loco  dicto. 

91  Children's  diseases,  ch.  i. 

92  Loco  dicto. 


CORNELIUS  ROELANS  125 

gleaming,  manifest,  white  and  red  pustules  from  which  emanates  a 
bloody  corruption  if  they  are  pressed  and  the  place  is  without  itching 
with  a  redness  not  very  intense,  but  the  sick  person  feels  warmth  and  heat 
in  the  place  where  it  appears.  The  symptoms  of  the  second  species,  sc. 
the  dry,  are  intense  redness  with  yellowness  and  in  the  place  there  appear 
small  minute  pustules  which  rarely  emit  bloody  corruption  even  if  they 
are  pressed  with  the  hands,  the  place  becomes  crusty  and  has  a  vigorous 
itching  and  redness/ ' 

Prognostics.  Niccoli93  says:  "All  species  of  saphati  continue  to  loss 
of  hair  and  falling  of  the  hair  and  this  latter  more  or  less  according  to 
whether  the  matter  is  more  or  less  corrosive.  And  sometimes  it  continues 
to  alopecia  and  tyria  and  sometimes  to  ulceration  which  flows  forth  on 
the  cutis  and  even  to  the  flesh  which  is  under  it  and  especially  when  it 
grows  old." 

Cure.  Mesue94  says:  "The  cure  of  saphati  is  four  things.  The  first, 
cleansing  of  the  head  from  the  humor  whose  malignance  it  seems  to  be. 
The  second  is  equalizing  in  the  body  and  changing  the  regimen  to  those 
things  which  are  instruments  of  laudable  matter  and  this  is  a  laudable 
regimen  in  the  six  classes  of  things  not  natural.  The  third  is  occupation 
about  that  which  was  done  from  malignance  in  the  cutis.  The  fourth  is 
correction  of  the  accidents  or  assistance  for  the  regeneration  of  the  hairs 
torn  out." 

Niccoli93  fulfills  the  cure  of  saphati  by  three  intentions.  The  first  is 
the  regimen  of  diet;  the  second  the  regimen  of  potion;  the  third  corrects 
the  accidents.  The  compiler  of  the  work:  "The  regimen  of  saphati, 
when  it  occurs  in  infants,  whether  it  be  moist  or  dry  saphati,  should  be 
turned  toward  the  nurse  and  to  regulate  her  according  to  what  is 
appropriate  and  necessary."  Niccoli  (as  above):  "The  first  intention, 
sc.  diet,  in  dry  saphati  should  be  that  the  diet  of  the  nurse  be  turned  to 
moistening."  Avenzoar  says:  "They  should  not  recommend  sweet  things 
because  the  matter  is  choleric.  They  should  not  turn  their  head  (sc.  nor 
face)  toward  the  sun  or  the  light  and  they  should  guard  themselves 
from  vinegar  by  itself  and  portulacca  altogether.  I  think  this  is  not  on 
account  of  the  complexion  of  portulacca  but  on  account  of  the  appropri- 
ateness which  it  has  herein.  And  they  should  guard  themselves  from 
every  kind  of  milk  and  from  everything  which  might  have  changed  its 
flavor  on  account  of  the  passage  of  time  and  from  all  things  roasted  or 
fried  in  Iactage  and  from  every  kind  of  fish  and  eggs,  because  in  differ- 
ent ways  these  things  harm,  and  from  fruits  except  sweet  pomegranates 
and  from  the  insides  of  saracen  cucumbers,  i.e.  watermelons,  since 
from  eating  them  they  are  by  no  means  injured,  rather  are  they  recom- 

93  Loco  dicto. 

9 A  Appropriatae,  n,  part  I,  ch.  iii. 


126  PEDIATRICS  OF  THE  PAST 

mended  for  carrying  off  the  malignant  humor  through  the  urine.  And 
make  them,,,  says  Avenzoar,  "odorate  themselves  in  the  morning  with 
roses  of  myrtle  or  water  lilies." 

Rases95  says:  "Begin  in  the  cure  of  their  saphati  (sc.  of  those  ill  with 
the  disease)  by  correcting  the  food  of  the  nurse."  Avicenna96  says: 
"They  (sc.  nurses)  should  abandon  everything  that  has  superfluous 
sweetness  and  particularly  dates,  because  they  carry  matter  to  the  cutis, 
and  everything  which  has  bitterness  or  sharpness  or  saltiness,  and  be 
content  in  the  moistening  of  the  body  with  equal  humidity  in  the  bath 
and  in  other  ways.  And  conversely  the  regimen  in  moist  saphati  should 
be  turned  toward  the  drying  up,  yet  more  or  less  according  to  the 
diversity  of  the  matter.  The  diet  therefore,  according  to  Avenzoar, 
should  be  desiccative  by  giving  turtledoves,  small  grove  birds,  roasted 
on  the  spit  or  on  a  tile  with  vinegar  and  almuri  and  give  her  bread 
well-fermented  with  oil  and  a  dash  of  salt. 

Second  intention,  sc.  evacuation.  Galen97  says  it  happens  through 
compression  of  the  malignant  humor  and  therefore  she  should  be  purged, 
if  her  strength  is  sufficient,  and  this,  he  said,  on  account  of  the  infants. 
Avicenna98  says:  "The  common  vein  should  be  phlebotomized  when 
necessary  or  the  vein  which  feeds  the  member  in  which  it  is,  as  when 
it  happens  on  the  head  the  vein  of  the  forehead  or  when  it  happens 
on  the  skin  of  the  head  the  vein  behind  the  ears,  and  if  in  the  lower  mem- 
bers, the  saphena,  and  these  should  be  phlebotomized  if  there  has  not 
been  repletion  completely  or  if  the  phlebotomy  of  the  universal  vein 
precedes,  and  it  is  not  a  bad  thing  to  apply  leeches  upon  her."  And 
ventose  things  with  scarification  around  the  ears  or  in  the  ears  are  potent 
when  it  happens  on  the  head.  "In  dry  saphati  the  evacuation  of  the 
choleric,  melancholy  humor  and  the  salt  phlegm,"  says  Avicenna, 
"should  be  effected  with  things  like  a  decoction  of  myrobalan  and  thyme 
in  which  is  put  some  aloe  and  scammony.  And  after  the  diminution  of 
the  matter,  let  the  remainder  be  evacuated  with  cheese-water  and  thyme 
according  to  what  the  strength  bears."  In  moist  saphati  Avicenna  did 
not  describe  because  he  left  a  note:  "But  if  evacuation  is  necessary 
in  the  dry,  much  more  should  be  done  in  the  moist."  Therefore  according 
to  what  is  appropriate  for  the  one  guilty  of  humors.  Avenzoar  said:  "If 
the  child  is  knowing,  you  will  give  it  to  drink  some  hiera  once  in  ten  days 
in  an  amount  suitable  to  its  strength  and  age."  Avenzoar  said:  "In 
melancholy  (sc.  moist  as  well  as  dry),  if  the  patient  can  stand  it,  you 
will  give  it  to  drink  in  the  morning  on  an  empty  stomach  one  Indian 

*&  Children's  diseases,  ch.  i. 

99  Bk.  iv,  fen  vn,  tractate  3,  ch.  ii. 

91  Miamir,  i. 

98  Loco  dicto. 


CORNELIUS  ROELANS  127 

myrobalan  triturated  and  sifted  (sc.,  and  in  the  choleric  you  will  give  a 
yellow  myrobalan  and  in  phlegmatic  a  chebule  or  emblic)." 

The  third  intention,  sc.  correction  of  the  accidents,  is  fulfilled  by 
locally  applied  remedies,  among  which,  says  Niccoli,  is  the  frequent  abra- 
sion of  the  head.  For  it  is  beneficial  in  the  dry  and  the  moist,  but  in  the 
dry  it  becomes  more  subtle;  and  after  the  abrasion  let  an  ablution  be 
made,  in  the  dry  with  water  of  a  decoction  of  leaves  of  fumitory  and 
camomile  and  in  the  moist  with  the  lye  of  a  decoction  of  the  aforemen- 
tioned herbs,  and  in  addition  let  other  medicines  be  applied  which  are 
different  according  to  whether  the  saphati  is  dry  or  moist  and  according 
to  whether  they  are  new  or  old. 

Rases99  says:  "Rub  the  head  of  the  child  with  psilothrum,  i.e.,  a 
depilatory  medicament;  then  place  on  it  leaves  of  atriplex,  because  per- 
haps it  is  to  be  cured  through  this  much,  since  those  leaves  suck  out  the 
poison,  or  place  upon  it  this  ointment  efficacious  for  saphati  which  occurs 
on  the  heads  of  children : 


1^  cerusae,  Iithargirii ana  5v 

Iixivii  de  cineribus  vitium  (in  alio  habetur  de 

cinere  urtica) 5iii 

olei  rosarum 5  i 

cerae 5  i 

Let  the  wax  be  melted  with  the  oil  of  roses  and 
let  the  medicines  be  ground  up  and  let  a  confec- 
tion be  made  of  them  with  the  roasted  yolks  of 
two  eggs.  Then  anoint  the  child's  head  with  it." 


The  seventh  disease  of  children  is  favosity  of  honey.100  The  disease 
which  is  called  favosity  of  honey  is  a  species  of  saphati  and  is,  according 
to  Jacques  Despars,101  and  this  on  the  authority  of  Rases  in  the  same 
passage,  favosity,  sc.  a  crusty  tinea  from  which  flows  a  malignant 
humidity  similar  to  a  honey  comb. 

The  symptoms.  Says  Rases:102  "Wounds  appear  like  scales  and  the 
cutis  is  scratched  with  great  itching  and  a  liquid  issues  from  them  like 
honey." 

The  cure,  according  to  the  same  authority,  is :  Let  the  head  be  shaved 
daily  and  washed  with  water  of  horse-mint  and  of  majoram  and  of  savory 

99  Regimen  of  children's  diseases,  ch.  i. 

100  Rases.  Children's  diseases,  ch.  i. 

101  On  Avicenna,  bk.  i,  fen  in,  doct.  I,  ch.  iii  at  the  end  of  the  chapter. 
1M  Loco  dicto. 


128  PEDIATRICS  OF  THE  PAST 

(saturegia,  otherwise  satureia).  Then  let  it  be  anointed  with  the  following 
ointment : 

If  Iithargirii,  cerusae ana  aureos  ii 

sulphuris  et  argenti  vivi ana  aureum  i 

olei  rosati partes  ii 

aceti partem  i 

Let  them  be  mixed  and  a  confection 
made  with  oil  of  rose  and  vinegar  until  it 
becomes  an  ointment  and  anoint  there- 
with evening  and  morning  and  wash  the 
head  with  that  water. 

The  compiler:  "On  the  regimen  of  this  disease,  the  discussion  in 
general  has  preceded  in  the  fifth  disease  of  children  nor  would  I  have 
specified  that  seventh  from  the  sixth  unless  I  had  followed  Rases  in  his 
little  book  of  children's  diseases  and  Jacques  Despars  in  the  places 
mentioned  who  treat  of  them  in  different  ways.  There  are  nevertheless 
both  species  of  saphati. 

The  eighth  disease  of  children  is  wakefulness  and  insomnia  of 
children.103  Wakefulness  is  an  animate  disposition  when  the  animate 
spirits  are  poured  forth  toward  the  instruments  of  sensation  and  motion 
so  that  it  uses  them.  "Sahara,  i.e.,  superfluous  wakefulness  or  wakeful- 
ness on  account  of  nature,"  says  Niccoli,104  or  "persistence  of  wakeful- 
ness," according  to  Avicenna, 105  is  superfluity  in  wakefulness  and  depar- 
ture from  natural  condition.  Avicenna106  says:  "It  happens  to  an  infant 
that  it  does  not  sleep  and  cries  incessantly  and  moves  its  mouth  by  con- 
tinually squalling."  Hippocrates107  makes  mention  of  this  wakefulness. 
Galen  in  commenting  upon  him  says:  "Wakefulness  does  not  happen  to 
children  naturally  nor  from  habit,  i.e.,  customarily,  for  they  always 
sleep.  But  nevertheless  if  from  voracity  the  stomach  becomes  weak,  its 
foods  are  corrupted  and  their  smoke  ascending  to  the  head  generates 
wakefulness  and  fears." 

Cause.  Rases108  says:  "Wakefulness  happens  to  children  in  the 
first  years  from  corruption  of  the  milk."  The  compiler  says  the  cause  is 
voracity  whereby  the  food  is  corrupted,  the  smoke  of  which  ascends  to 
the  anterior  cerebrum  inducing  wakefulness. 

The  symptoms  are  known  from  the  thing  itself. 

103  Avicenna,  bk.  in,  fen  i,  tractate  4,  ch,  iv. 

104  Sermo  in,  tractate  2,  summa  4,  ch.  x. 
106  Loco  dicto. 

106  Bk.  1  fen.  in,  doct.  1,  ch.  iii.    % 

107  Aphorisms,  in,  25. 

108  Children's  diseases,  ch.  vi,  and  Experiments,  xxv. 


CORNELIUS  ROELANS  129 

Prognostics.  Hippocrates109  says:  "In  wakefulness  (sc.  more  than 
ordinary)  spasm,  sc.  on  account  of  inanition  or  decipiency,  i.e.,  any 
lesion  of  the  cogitative  power,  which  is  bad,  because  it  signifies  vigorous 
drying  up  and  weakness  of  the  power."  Gordon110  on  the  authority  of 
Avicenna111  says:  "If  in  addition  to  the  wakefulness  a  cough  (sc.  dry) 
should  come,  it  is  a  fatal  sign  because  it  signifies  a  dryness  communi- 
cated to  the  spiritual  members.' ' 

Cure.  Gordon  112  on  the  regimen  of  diet  speaks  as  follows:  "In  all 
diseases  of  infants  the  diet  of  the  nurse  should  be  rectified,  since  generally 
children's  diseases  come  from  a  malignance  of  the  milk.  If  there  be 
repletio  or  intoxication,  she  should  be  phlebotomized  if  from  the  intoxi- 
cation abstinence  is  perceived;  if  there  be  inanition,  let  her  be  repleted, 
let  the  malignant  complexion  be  rectified  and  let  her  use  praiseworthy 
foods,  moderate  exercise,  sleep  and  laxatives  when  it  is  necessary  and  it 
will  be  more  potent  for  the  cure." 

Rases113  says:  "Let  there  be  introduced  into  the  child's  nostrils  oil  of 
violets  with  vinegar  or  oil  of  dill  with  the  juice  of  lettuce.  And  anoint  the 
head  and  the  stomach  with  those  oils  and  let  there  be  care  in  the  correc- 
tion of  the  milk  and  give  the  child  syrup  of  white  poppy  to  suck  and 
anoint  the  temples  and  forehead  with  oil  of  opium  and  saffron. 

Avicenna,114  as  Jacques  Despars  says  in  explanation  of  that  text, 
proposes  four  remedies  of  moderate  virtue  against  the  aforementioned 
cases.  The  first  remedy  producing  sleep  is  capsules  of  poppy  triturated  if 
you  wish  with  a  modicum  of  rose  water  and  spread  it  upon  a  linen  cloth 
and  apply  or  place  upon  the  forehead  and  temples  and  crown  of  the 
infant.  The  second  is  the  seed  of  the  poppy  which  you  can  triturate  by 
infusing  a  little  with  rose  water  and  woman's  milk  in  equal  parts  until  it 
becomes  like  pottage  and  spread  it  thin  upon  a  linen  cloth  placing  it 
upon  the  crown,  forehead  and  temples  and  take  the  capsules  as  well  as 
the  seed  of  the  white  poppy  because  with  its  stupor  it  is  domestic,  i.e.,  of 
familiar  nature,  while  the  black  is  not  so,  as  Jacques  says  on  the  authority 
of  Avicenna.115  The  third  is  oil  of  lettuce  smeared  on  the  forehead, 
temples  and  crown.  The  fourth  is  oil  of  poppy  likewise  smeared.  Then, 
says  Jacques  Despars,116  from  these  four  may  be  compounded  the  follow- 
ing sleep-producer: 

109  Aphorisms,  vn,  8. 

110  Bk.  v,  ch.  xvii,  part  2. 

111  Loco  iam  dicto. 

113  Regimen  of  health,  ch.  iv. 

119  Experiments,  ch.  xxv,  or  Children's  diseases,  ch.  vi. 

n*  Bk.  1,  fen  in,  loco  iam  dicto,  sc.  doct.  1,  ch.  iii,  in  the  twenty-third  part  of  that 
chapter. 

115  Bk.  1,  fen  iv,  ch.  i. 

116  Loco  dicto. 


i3o  PEDIATRICS  OF  THE  PAST 

1$  corticum  papaveris  albi  et  seminis  eius       ana  5  \i 
oleorum  de  Iactuca  et  de  papavere  ana  quartam 

median 
Let  them  be  triturated  well  together  and 
embodied  and  let  an  ointment  or  liniment 
be  made  with  which  the  forehead  and 
temples  should  be  anointed. 

Note,  however,  that  although  all  these  are  domestic  sleep-producers, 
they  should  be  avoided  or  used  with  great  caution  in  infants  of  thick 
heads  very  replete,  because  from  the  easy  subeth117  they  might  induce 
apoplexy  or  paralysis  on  account  of  the  weakness  of  their  cerebra  and 
nerves. 

Avicenna118  afterwards  describes  a  medicament  stronger  than  those 
already  mentioned,  saying:  "Another  medicament  stronger  than  those: 

1$  seminis  sullae,  nucis  enden,  papaveris  albi, 
seminis  Iini,  granorum  chausi,  seminis  portu- 
Iacae,  seminis  plantaginis,  seminum  Iactucarum, 
seminis  feniculi,  anisi,  cumini  ana  5i 

Let  all  these  be  torrefied  gradually,  afterwards 
let  them  be  triturated  and  let  there  be  added 
thereto  one  dram  of  psyllium  torrefied  but  not 
pulverized;  then  let  them  be  mixed  with  twelve 
drams  of  sugar  and  of  this  preparation  let 
there  be  given  to  the  infant  two  drams  to  drink 
with  tisane  or  boiled  water  or  chicken  broth." 

Jacques  Despars,  after  he  directed  that  these  ingredients  should  be  so 
prepared,  makes  the  following  statement:  "Sulla,  i.e.,  in  the  synonyms 
of  Avicenna  it  is  explained  that  it  is  an  arthetic  herb  and  in  a  similar 
book  of  Almanzor  in  its  place  is  had  sausucus  and  it  is  marjoram.  Nux 
enden  or  henden  is  described  by  Avicenna119  as  grainy  earth  like  a  white 
chick-pea  declining  toward  yellowness  which  is  derived  from  the  bark 
and  the  coroscen  from  which  together  with  honey  a  wine  is  made."  And 
in  a  marginal  gloss  of  the  present  letter  which  I  believe  is  that  of  the 
translator  of  Avicenna  it  is  described  as  earth  formed  to  the  likeness  of  a 
nut  which  immersed  in  must  makes  wine  as  if  it  were  for  six  months 
casting  off  its  lees.  Granum  chausin  is  the  seed  of  celandine.  Psyllium  in 
this  enumeration  is  not  triturated  as  the  other  ingredients  because  its 
interior  medullar  substance  is  warm  and  dry  in  the  fourth  degree  and 

117  Unhealthy  sleep,  subeth  Avicenna,  was  an  old  name  for  coma. 

llBLoco  dicto. 

119  Bk.  II.  tractate  2,  ch.  Ivi. 


CORNELIUS  ROELANS  131 

is  sharp,  strongly  incisive,  rubificative,  ulcerative,  and  is  of  the  genus  of 
poison.  But  its  exterior  substance  spread  upon  the  capsule  is  of  good  cool 
producers,  as  Mesue  says.120  And  here  there  is  only  question  of  the 
exterior  substance  alone.  It  is  better  therefore  that  the  interior  part 
remain  cloaked  and  come  out  with  the  lees,  not  withdrawn  from  the 
potency  to  act  by  division  and  impression  of  the  innate  heat. 

Here  someone  perhaps  may  ask  how  in  this  medicament  warm  and 
dry  medicines  such  as  seed  of  fennel,  of  anise,  of  cumin,  are  of  service, 
when  they  seem  rather  by  their  warmth  and  dryness  to  arouse  wakeful- 
ness. Here  Jacques  Despars  says  that  they  consume  the  vapors,  fumes 
and  ventosities  which  stir  up  pains  and  insomnia,  just  as  in  filonium 
warm  medicines  assuage  by  resolving  the  ventosities  and  cool  ones  pro- 
voke sleep.  Avicenna  afterwards  says:  "And  if  you  wish  to  make  a 
stronger  medicament,  add  thereto  one  scruple  or  less  of  opium,  sc.  a 
third  part  of  one  of  its  simples.  For  of  anything  except  sugar,  there  was 
laid  down  one  dram,  a  third  part  of  which  is  one  scruple. 

Opium  is  the  juice  of  the  black  Egyptian  poppy,  for  it  is  cool  and 
dry  in  the  fourth  degree  of  narcotics  sedative  of  all  pain  whether  it  be 
drunk  or  smeared.  And  the  potion  of  it  should  be  the  size  of  a  lentil,  as 
the  eminent  Avicenna  says.121  Gordon  122  against  wakefulness  of  children 
says:  "Let  there  be  placed  on  their  forehead  and  temples  cloths  soaked 
in  the  milk  of  the  woman  nursing  the  child  and  oil  of  roses  and  meal  of 
white  poppy.  And  if  there  shall  be  great  necessity,  let  there  be  added 
with  these  the  juice  of  lettuce,  portulacca  vermicularis  and  a  modicum  of 
opium.  In  a  certain  little  old  treatise  on  children's  diseases  I  found:  If 
the  infant  suffer  insomnia,  let  there  be  made  fomentations  of  cool  herbs 
in  a  decoction,  sc.  mallows,  lanceolate  plantain,  i.e.,  plaintain  minor, 
with  populeon  and  oil  of  roses  or  of  violets  mixed  together  with  the  juice 
of  mandrake,  portulacca  and  lettuce.  In  all  these  let  there  be  soaked  a 
cloth  which  is  placed  upon  the  forehead  and  temples. 

Likewise  let  oil  of  violets  be  mixed  with  woman's  milk  or  with  oil  of 
roses  and  the  forehead  and  temples  be  anointed. 

The  ninth  disease  of  children  is  fear  in  dreams  or  they  are  nightmares 
of  children  or  dreams  terrifying  them.123  Avicenna:  "To  the  infant 
happen  dreams  terrifying  in  its  sleep."  Hippocrates124  makes  mention 
of  it,  naming  fears  among  the  diseases  of  the  newly  born  in  that  canon. 
But  its  cause  in  early  ages  Galen  in  his  comment  attributed  to  the 
corruption  of  the  milk,  saying:  "If  the  stomach  is  weak  from  voracity, 
its  foods  are  corrupted  and  their  smoke  ascending  to  the  head  generates 

120  De  consolatione  medicinarum,  II,  ch.  xx,  part  2,  ca.  psyllium. 

121  Canon  11,  tractate  2,  ch.  dxxviii,  1 .  opium. 

122  Regimen  of  health,  ch.  iv. 
128  Bk.  1,  fen  in,  doct.  1,  ch.  iii. 

124  Aphorisms,  in,  25,  s.  v.  timores. 


1 32  PEDIATRICS  OF  THE  PAST 

wakefulness  and  fears,  a  fact  which  I  have  also  proved  in  early  ages, 
things  done  in  sleep  seeming  terrible  when  they  are  fed  on  bad  food  and 
especially  if  the  mouth  of  the  stomach  be  weak."  Jacques  Despars125  says: 
"Terrible  dreams  of  infants  as  happen  in  many  from  superfluous  reple- 
tion of  food  which,  since  it  cannot  be  digested  by  nature,  is  corrupted  in 
the  bowels,  and  injury  therefrom  is  felt  by  the  stomach  and  it  proceeds 
from  its  sensible  power  to  the  formative  power,  i.e.  phantasy,  which 
retains  forms  of  sensible  things  perceived  by  the  common  sense,  and 
to  the  imaginative  power  which  operates  around  them." 

Galen126  makes  mention  of  almost  the  same  opinion,  saying:  "For  it 
seems  in  dreams  an  air  going  to  the  depth  of  the  body  directly  from  the 
outside  is  sensible  of  those  things  which  are  sensed  according  to  the 
arrangement  of  the  body  and  again  he  who  desires  it  receives  a  phantasm 
of  these  things  as  being  already  present  and  since  this  is  so,  it  will  surely 
be  wonderful  if,  when  the  airy  power  is  weakened  under  the  weight  of 
the  multitude  of  humors,  they  fancy  they  can  scarcely  move  even  carry- 
ing some  loads  and  they  think  they  have  reached  fetid  and  odoriferous 
things  and  that  even  those  indeed  who  fancy  themselves  living  in  dirt 
and  filth  have  either  bad  and  fetid  and  putrid  humors  or  a  large  quantity 
of  excrement  in  the  intestines." 

Rases127  treats  of  these  dreams  under  the  title  of  "mistress  of 
children,"  as  Jacques  Despars128  says,  speaking  of  this.  "This  infirmity, 
which  is  called  'the  mistress  of  children*  (sc.  happens)  to  children  fre- 
quently at  an  early  age." 

Its  cause,  as  the  same  authority  says,  is  the  taking  of  more  milk 
than  it  can  digest,  wherefore  it  is  corrupted.  Gordon129  says:  "Fear  in 
dreams  happens  because  of  a  corruption  of  the  milk  (sc.  or  food)  in  the 
stomach." 

The  symptoms,  says  Rases130  are  much  crying  or  wailing,  fear  in 
sleep  and  in  wakefulness,  the  heat  is  increased  and  from  its  mouth  a 
fetid  odor  issues. 

Cure.  Avicenna130  and  Jacques  Despars  thereon  give  two  remedies. 
First,  let  the  infant  be  not  forced,  rather  let  it  not  be  permitted,  to  sleep 
while  its  stomach  is  full  of  food,  but,  says  Jacques,  with  games  and 
carryings  about  let  it  be  kept  awake  until  its  food  shall  have  descended 
from  the  orifice  of  the  stomach  and  this  through  vapors  and  let  copious 
fumes  be  prevented  from  seeking  its  cerebrum.  The  second  is:  Let  a  little 
honey  be  given  to  the  infant  to  lick  which  it  should  direct,  i.e.,  cause  it 

125  On  Avicenna,  loco  iam  dicto. 

126  In  his  little  book,  De  somniis. 

127  Book  of  experiments,  ch.  xxvii,  or  Book  of  children's  diseases,  ch.  viii. 

128  On  Avicenna,  loco  iam  dicto,  sc.  bk.  i,  fen  in,  doct.  i,  ch.  iii,  27th  part. 

129  Regimen  of  health,  ch.  iv. 

130  Loco  dicto. 


CORNELIUS  ROELANS  133 

to  descend  by  its  own  abstersive  power  or  digest,  as  others  have  it, 
i.e.,  aid  that  which  is  in  the  stomach  to  be  digested,  and  put  it  aside  from 
the  orifice  of  the  stomach  collecting  it  towards  its  bottom. 

Rases131  says  its  cure  is  in  the  curing  of  the  milk  and  that  there 
should  be  given  to  the  child  daily  of  diapliris  or  of  diamusco  one-sixth  of 
a  dram,  sc.  half  a  scruple,  with  milk,  and  the  principal  medicine  in  this 
is  magna  tyriaca  given  with  milk.  Gordon132  says:  "Let  it  (sc.  the  milk 
or  food)  be  diminished  and  let  it  lick  honey." 

The  thirteenth  disease  of  children  is  alcuzen,  i.e.,  tetanus  of  children. 
The  compiler  of  the  work:  "The  normal  and  real  signification  of  tetanus 
is  clear  from  the  preceding  twelfth  disease  of  children.  Tetanus  in  Arabic 
is  called  cuzen  or  alcuzen.  It  is  called  tetanus  from  stretching  (tendere) 
and  is  particularly  a  stretching  of  a  member  or  members." 

Avicenna133  says:  "Alcuzen  or  cuzen  according  to  the  ancients  signi 
fies  these  five.  First,  they  call  cuzen  that  spasm  which  begins  from  the 
muscles  of  the  furcula  and  extends  them  up  or  down  or  in  both  directions 
at  the  same  time.  Secondly,  they  call  every  tetanus  cuzen.  Thirdly,  they 
call  cuzen  particularly  a  spasm  of  the  eye.  Fourthly,  they  signify  that  which 
is  two  spasms  or  two  tetani  lower  and  upper.  Fifthly,  that  tetanus  which  is 
made  congealed  by  cold." 

Jacques  Despars134  says  that  to  the  infant  happens  alcuzen,  i.e., 
tetanus.  And  it  is  (sc.  on  the  authority  of  Avicenna135 )  an  official  disease 
preventing  the  motive  power  from  the  contraction  of  members,  although 
they  have  a  natural  tendency  to  be  contracted  on  account  of  the  injury 
in  the  muscles  and  nerves.  Now  tetanus  is  contrary  to  spasm.  For 
spasm  contracts  the  member  together,  but  tetanus  stretches  the  member 
and  prevents  contraction.  Now  what  Niccoli136  says  is  stretched  is  con- 
trary to  contracted  and  doubled  up. 

Tetanus  is  divided  with  the  same  division  as  spasm.  For  one  is  from 
repletion,  the  other  from  inanition,  and  one  is  not  proportioned  to  the 
matter  and  the  other  is  a  combination  of  these  species.  And  similarly  one 
is  anterior  and  the  other  posterior.  The  anterior,  says  Rases137  is  that 
which  occurs  in  the  anterior  muscles,  and  the  posterior  that  which 
occurs  in  the  posterior.  Add:  and  one  is  on  the  right  and  the  other  on  the 
left.  Similarly  add:  one  is  a  combination  of  these  and  when  they  are 
thus  they  are  merely  tetani  and  not  double  spasms,  sc.  when  they  are 
simple. 

131  Loco  dicto. 

132  Sermo  in,  tractate  2,  summa  4,  ch.  xiii. 

133  Bk.  in,  fen  11,  ch.  viii. 

134  On  Avicenna,  bk.  1,  fen  in,  doct.  1,  ch.  iii,  in  the  seventh  part  of  the  chapter. 

135  Bk.  in,  fen  n,  ch.  viii. 

133  Sermo  in,  tractate  3,  ch.  viii. 
197  Continens,  n. 


i34  PEDIATRICS  OF  THE  PAST 

Causes  of  alcuzen,  i.e.,  of  tetanus.  Avicenna138  says:  "They  are 
similar  to  the  causes  of  spasm,  according  to  one  method  and  different 
from  them  by  another  method.  Their  similarity  with  them  is  that 
sometimes  cuzen  occurs  from  repletion  andjsometimes  from  dryness 
and  that  on  account  of  the  injury  resulting  to  the  nervous  members 
it  also  sometimes  occurs  from  apostemata.  Their  diversity  therefrom 
is  that  spasm  only  rarely  happens  from  extensive  ventosity,  while 
alcuzen,  which  is  a  combination  of  two  spasms  sometimes,  nay  generally, 
happens  from  ventosity,  when  it  predominates  in  the  body,  and  this  is 
a  perverse  disease.  But  when  a  single  spasm  occurs  in  a  member  from 
ventosity,  it  is  not  bad." 

"The  symptoms  of  moist  and  dry  and  apostematic  tetanus  and 
tetanus  due  to  lesion,"  says  Avicenna,139  "are  according  to  the  rule 
which  was  stated  in  spasm.  The  difference  of  tetanus  from  spasm  in  their 
beginning  is  that  spasm  begins  in  the  muscles  with  motion,  while  tetanus 
in  its  beginning  is  in  the  muscles  with  rest." 

Prognostic.  Alcuzen,  i.e.,  tetanus,  often  happens  in  infants  and 
happens  in  them  the  more  easily  the  younger  they  are  according  to  the 
statement  made  in  spasm. 

The  cure.  Avicenna140  proposes  two  remedies.  The  first  is:  alcuzen, 
when  it  happens  in  infants,  is  to  be  cured  with  water  in  which  siccidis  is 
boiled.  Jacques  Despars  hereon  says:  "Siccidis,  i.e.,  cucumis  asininus, 
whose  power  is  abstersive,  warming,  mollifying  and  resolving,  as  Serapio 
says  in  his  compilation."141  The  second  is  the  anointing  of  the  Iesioned 
nerves  with  oil  of  violet  together  with  siccionium  oil,  i.e.,  from  the  root 
of  the  cucumis  agrestis,  equally  mixed,  says  Jacques,  as  by  oil  of  violet 
the  rigid  nerves  are  softened  again  and  by  siccionium  oil  the  humidities 
with  which  they  are  filled  are  resolved. 

138  Loco  iam  dicto. 

139  Bk.  in,  fen  n,  ch.  ix. 

140  Bk.  i,  fen  III,  doct.  I,  ch.  iii. 

141  Part  II,  ch.  cc. 


SEBASTIAN  OESTEREICHER 

[?-i55o] 
Translator  of  Roelans 

SOME  fifteen  years  after  his  death,  Roelan's  work  was  "resur- 
rected" with  considerable  change  by  Sebastian  Oestereicher 
of  Russach  in  Alsace.  In  this  work,  as  Sudhoff  says,  "der 
natlirlichen  Kunst  Doctor* '  in  Latin  becomes  "Sebastianus 
Austrius,  der  Artznei  Doctor."  Oestereicher  died  in  Freiburg  in 
Breisgau,  in  1550. 

Ostericher  or  Oestereicher  was  somewhat  of  a  personage  in 
his  day  and  is  mentioned  in  various  archives  of  the  period.  He 
published  a  work  entitled  "De  secunda  valetudine  tuenda;  in 
Pauli  Aeginetae  Iibrum  explanatio."  This  was  printed  in  1538 
at  Strassburg  by  Johann  Schott  and  two  years  later  his  reworking 
of  Roelans  was  published  in  Basel  by  Westheimer.  It  is  entitled : 

"De  infantium  sive  puerorum,  morborum,  et  symptomatum, 
diagnotione,  turn  curatione  liber:  ex  Graecorum,  Latinorum  et 
Arabum  placitis,  atque  scitis  diligenter  erutus,  concinnatus,  et  in 
publicam  utilitatem  editus,  a  Sebastiano  Austrio  Rubeaquensi, 
apud  Argentuariorum  Colmariam  medico." 

Oestereicher  mentions  Roelans*  name  "a  quodam  Cornelio 
nomine,  Archiatro  Mechlingense  dedicatum,"  etc.,  and  states 
that  he  has  added  to  it  and  translated  it  out  of  the  "Kitchen 
Latin."  Sudhoff  says  that  Oestereicher  made  out  of  Roelans  a 
readable  book,  readable  in  the  sense  of  the  sixteenth  century. 
The  work  was  popular  or  at  any  rate  it  was  reprinted  various 
times,  notably  by  Gulielmus  Rovillus  in  Lyons  in  1549.  The 
title  of  this  edition  is  as  follows : 

DE  //  PVERORVM  //  MORBIS,  ET  SYMPTO-  //  matis  turn 
dignoscendis,  turn  //  curandis  Liber,  //  Ex  Graecorum,  Latinorum  et 
Arabum  pla-  //  citis  excerptus  a  SEBASTIANO  AV-  //  STRIO  Rube- 
aquensi apud  Argentua-  //  riorum  Colmariam  medico.  // 

ADJECTI  sunt  Hippoc.  Aph.  aliquot  de  //  nouiter  natorum  adfecti- 
bus,  alii  item  //  Aphoristici  sensus  ex  variis  //  authoribus,  //  De 
eorundem  bona  valetudine  tuenda. 

135 


D  B 

PVERORVM 

MORBIS,   ET  SYMPTCX 

mat  if  rum  dignofccndisjHm 

curandif  Liherr 

1ixGr4t$rum,latinortun  &  ArabumpU 
iitit excerpti* a s B  b  astta  no  av- 
STMO  Kubeaqucnfi apud  ArgentHA* 
riorum  Colntariam medico. 

^OtHCTI  fune  Hippoc.  Apt.  aliquot  i§ 

nouiter  natorum  adfe£Hbu$,  alii  item 

Aphoriftici  fenfus  ex  variis 

authoribus* 

De  eorundem  Bona -valet udine  tuenda. 


IV    GDVNr*. 

^piiGulielRomlfHhfcmo  Vznzto\ 

Title  page  of  the  work  of  Sebastian  Oestereicher. 


SEBASTIAN  OESTEREICHER  137 

[A  sign  of  an  eagle  and  serpent.]  LVGDVNI,  //  Apud  Guliel.  Rouil. 
Sub  Scuto  Veneto.  //  1549. 

Nicolaus  Fonteyn  (Fontanus),  a  physician  in  Amsterdam, 
reprinted  the  work  with  the  addition  of  some  Hippocratic  apho- 
risms; by  this  time  the  name  of  Roelans  was  forgotten.  The  title  is: 
NICOLAI  FONTANI  //  Commentarius  //  In  //  SEBASTIANVM 
AVSTRIVM,  //  Medicum  Caesareum,  //  De  //  Pverorvm  Morbis. 
//In  frontispicio  //  adjecti  Aphorismi  Hippocratis,  noviter  //  natorum 
adfectus  enarrantes.  //  [Sign  of  an  angel.]  //  AMSTELODAMI  //. 
Apud  IOANNEM  IANSSONIVM.  .  //  CI3  ID  CXLII. 

SudhofF  in  commenting  on  this  edition  states  that  the  text 
used  was  taken  from  the  1540  edition  printed  at  Basel.  This  is 
preceded  iy  some  Hippocratic  aphorisms. 

PEDIATRIC  APHORISMS   FROM  SEBASTIAN  OESTEREICHER  (1540)1 

Translated  by  Albert  Allemann,  m.d. 
Library  of  the  Surgeon-General's  Office 

1.  A  wet-nurse  of  good  morals,  good  constitution  and  in  the  prime 
of  life  is  always  to  be  chosen. 

2.  If  nurses  keep  a  good  diet,  they  will  produce  milk  of  good  com- 
position, supplying  rich  juices  to  the  growing  child. 

3.  Up  to  dentition,  feed  the  child  on  milk  alone. 

4.  Since  we  are  made  of  it  and  nourished  by  it,  the  mother's  milk, 
generated  from  accustomed  and  known  blood,  is  more  suitable  to  the 
infant's  welfare  than  other  natural  milks. 

5.  As  young  goats  fed  by  sheep  produce  finer  hair  and  Iambs  fed  by 
goat's  milk  produce  coarser  wool,  so  too,  children  brought  up  by  strange 
mothers  differ  markedly,  in  essential  characteristics,  from  their  own 
mothers. 

6.  Those  who  abandon  their  infants,  who  thrust  them  from  them- 
selves and  give  them  to  others  to  bring  up,  cut  and  destroy  the  spiritual 
bond  and  the  affection  by  which  nature  binds  parents  to  their  children. 

7.  You  can  tell  that  an  infant  has  been  sent  away  from  home  to  nurse 
by  its  eyes:  for  the  strong  affection  for  the  mother  is  slowly  and  gradually 
extinguished  and  is  centered  alone  upon  her  who  nurses  the  child,  which 
has  no  further  inclination  or  love  for  the  one  who  gave  it  birth. 

8.  Moderate  crying  of  the  child  before  feeding  tends  to  dilate  the 
respiratory  organs,  strengthens  the  others  and  to  cleanse  the  head. 

9.  Teething  begins  in  children  at  the  seventh  month,  but  those  who 
absorb  milk  more  readily  develop  teeth  earlier. 

1  Sebastianus  Austrius.  De  puerorum  morbis,  Leyden,  1549,  pp.  327-33 1- 


138  PEDIATRICS  OF  THE  PAST 

10.  Since  it  is  not  well  to  add  fuel  to  fire,  a  well-brought  up  child 
should  seldom  taste  wine  and  its  nurse  not  at  all,  for  it  heats  the  body 
and  fills  the  head  with  vapors,  sometimes  producing  rage  and  insanity. 

1 1 .  Lest  its  growth  be  impeded,  a  child  should  not  be  troubled  with 
too  much  or  too  violent  exercise  from  seven  to  fourteen  years.  During 
that  period  the  spirit  should  be  adorned  with  good  manners  and  suitable 
knowledge. 

12.  Good  mental  habits  are  corrupted  by  bad  habits  in  relation  to 
food,  drink  and  exercise,  by  what  is  seen  and  heard  and  by  bad  music. 

13.  Children  who  have  been  ailing  for  years,  through  bad  mental 
habits,  are  cured  by  giving  an  opposite  direction  to  the  workings  of  the 
mind. 

14.  Inordinate  mental  emotion  in  small  children  should  be  strenously 
prevented,  wherefore  the  nurse  should  be  prudent  and  expert  as  to  the 
child's  habits. 

15.  When  the  body  is  growing,  increasing  in  size  and  acquiring 
strength,  it  requires  heat:  on  the  other  hand,  when  it  begins  to  decay, 
to  hasten  rapidly  to  ruin  as  something  matured  and  decayed,  it  is  of 
necessity  immoderately  cold. 

16.  Wine  and  beer  are  harmful  to  children  because  they  befog  the 
brain  and  perturb  the  mind  by  heat. 

17.  There  are  three  ways  of  lightening  the  pangs  of  infancy;  to  give 
it  the  breast,  gentle  dandling  and  a  pleasant  modulation  of  the  voice. 

18.  When  the  infants'  bowels  are  clogged  with  dry  feces,  they  may 
be  loosened  by  a  few  drops  of  turpentine  or  an  ounce  of  honey. 

19.  Red  coral  suspended  around  the  suckling's  neck,  from  the  mouth 
to  the  stomach,  prevents  the  vomiting  of  milk  and  aids  in  digestion. 


LEONELLI  FAVENTIDE  VICTORIUS 

[?-I520] 

1EONELLUS  FAVENTINUS  VICTORIUS,  DEVICTORI IS, 
also  known  as  Vettori  or  Vettorio,  was  born  in  Faenza 
-sd  in  the  Romagna,  studied  and  qualified  in  Bologna  where 
he  subsequently  practiced.  In  1473  he  assumed  the  role  of 
professor  of  logic,  philosophy  and  medicine  but  gave  this  up  and 
later  settled  in  Feltre  in  the  Province  of  Belluno  where  he  died  in 
1520.  He  followed  the  teachings  of  the  Arabian  physicians  and 
wrote  "  Practica  medicinalis.  Liber  de  medendis  morbis  membrorum 
omnium  totius  corporis  humani,  nunquam  antea  in  Iucem  editus. 
Hoc  opus  novum  et  antehac  nullibi  excusum  Joannes  Kufnerus 
Trochoreus  brevibus  scholiis  illustravit  (Ingolstadtii,  1545.)" 

He  also  wrote  another  little  volume  on  the  diseases  of  children 
entitled,  in  a  reprint  dated  1546,  "Leonelli  Faventinide  Victoris, 
De  aegritudinibus  infantiu  tractatus."  This  had  an  appendix  by 
George  Khufner  and  also  an  address,  the  latter  of  biblical  and 
mythological  allusions.  It  is  followed  by  a  congratulatory  ode  in 
Latin  to  Khufner,  and  four  other  Latin  poems  celebrating  the 
achievements  and  worth  of  the  commentator.  Not  an  unpleasing 
way  of  climbing  into  fame  on  the  back  of  some  other  author !  The 
"Tractatus"  was  published  in  Ingolstadt  in  1544  and  reprinted  in 
Lyons  1546,  1554,  1574,  and  Venice,  1557. 

Leonelli's  book  consists  of  thirty-three  chapters  mostly  on 
common  diseases  such  as  diarrhea,  constipation,  earache,  abscesses 
of  the  head,  weak  stomach,  disturbed  sleep.  His  method  is  simple. 
He  names  the  disease,  gives  its  cause  and  then  proceeds  to  its 
cure.  It  is  really  a  handbook  of  pediatric  therapeutics  and  he 
makes  much  of  fomentations,  inunctions,  and  the  external  use  of 
oils.  His  chapter  on  "Pain  in  the  Stomach"  may  serve  as  an 
example: 

CHAPTER  XVII.    ON  PAIN  IN  THE  STOMACH 

Pain  in  the  stomach  occurs  in  infants  sometimes  from  flatulence 
existing  in  the  intestines,  sometimes  from  the  coolness  of  the  atmosphere 

139 


140  PEDIATRICS  OF  THE  PAST 

or  some  other  cause  chilling  the  stomach;  sometimes  also  it  results  from 
worms  biting  the  intestines. 

Cure 

This  ailment  therefore  is  cured:  First,  by  rubbing  the  child's  stomach 
with  hot  water  and  fomenting  with  a  sponge.  For  it  opens  the  pores  of 
the  stomach  and  breaks  up  the  flatulence. 

It  is  effective  for  the  same  purpose  to  take  common  oil,  to  which 
should  be  added  a  modicum  of  crocus,  and  in  this  oil  immerse  rags  and 
apply  them  to  the  stomach. 

Fomentation  for  the  same 

1$  meliloti,  chamomillae  ana  M  ss. 

anisi,  foeniculi,  carui  ana  M  ss. 

Let  all  boil  in  half  a  measure  of  water 
until  half  has  boiled  away,  then  let  the 
place,  i.e.,  the  stomach,  be  fomented  with 
a  sponge  three  or  four  times.  Afterwards  let 
the  place  be  anointed  with  the  ointment 
described  below. 

Ointment 
1$  olei  chamaemelini,  Iiliacei,  anethini  ana  3  ss 

Mix,  let  an  anointing  be  made,  as  above. 

Cure 

The  cure  of  the  pain  arising  from  worms  is  to  be  had  in  the  cure  of 
worms. 

Khufner  added  sixty-one  chapters  on  various  remedies,  much 
in  the  style  and  arrangement  of  Victorius.  He  considers  the 
various  affections  of  the  anus,  of  the  hair,  heart,  teeth,  epilepsy, 
hernia  and  what  not.  Fevers  are  all  under  one  or  two  headings. 
He  gives  a  chapter  on  diabetes  which  he  ascribes  to  the  heat  of 
the  kidneys.  Many  of  our  present-day  writers  fall  into  the  same 
error  of  giving  an  explanation  for  a  disease  when  none  is  known. 
Khufner  gives  the  following  account: 

CHAPTER  LVI.   ON  EXCESS  AND  LACK  OF  URINATION,  AND  FIRST  ON 

DIABETES 

The  diabetic  disease  is  an  excessive  and  involuntary  flow  of  water. 
Its  cause  is  excessive  heat  of  the  kidneys,  gently  absorbing  the  wateriness 
of  the  blood. 


LEONELLI  FAVENTIDE  VICTORIUS  141 

The  symptoms  are:  Immoderate  and  unnatural  flow  of  urine;  indeed 
whatever  is  drunk,  quickly  passes  out  in  the  raw  state,  and  frequently 
the  urine  is  white  and  clear  because  of  its  rawness  and  indigestion. 

Prognosis:  This  disease  brings  on  extreme  emaciation,  and  unless  it 
is  attended  to  in  time,  dropsy  and  death  are  to  be  feared. 

Cure:  Milk  prepared  from  filberts  recently  broken,  in  a  confection 
of  water  of  urinative  herb,  is  wonderfully  beneficial  to  all  diabetics. 
Galen  recommends  barley  water,  given  to  drink,  and  rob  fructum. 

Among  the  simple  remedies  (are)  ends  of  vine,  quince-apples,  pome- 
granates, grass  of  willows,  purslane,  shepherd's  staff  and  evergreen, 
taken  separately  or  mixed,  after  the  manner  of  an  abscess  as  well  as  of 
fomentation  or  bath. 

Plaster  for  the  same 

1%  farinae  hordeaceae  5  "j 

Let  it  be  infused  in  oil  of  rose  q.  ss.  and  a 
modicum  of  vinegar.  There  may  also  be  added 
purslain  seeds,  a  shaving  of  cucumber,  and 
solatrum,  with  the  addition  of  cooling  seeds, 
small  as  well  as  large,  cleansed  of  their  bark; 
and  let  a  plaster  be  made  according  to  the  art. 


JONAS  AND  RAYNALDE 

INGERSLEV1  has  given  a  delightful  account  of  "De  Partu 
Hominis,"  an  early  work  on  obstetrics  by  Eucharius  Roslin, 
Rosslin  or  Rhodion,  as  he  is  variously  called,  a  physician  who 
lived  in  Worms  and  subsequently  in  Frankfurt-am-Main.  He  is 
supposed  to  have  died  in  1526.  In  15 13  he  published  "Der  Swan- 
gern  Frawen  und  Hebammen  Rosegarten,"  the  first  work  devoted 
entirely  to  obstetrics.  It  is  a  compilation  from  the  works  of  such 
early  masters  as  Hippocrates,  Galen,  Aetius,  Avicenna,  Albertus 
Magnus,  Gordon  and  Savonarola.  It  contains  a  series  of  obstetri- 
cal illustrations  printed  from  woodblocks.  This  "Rosegarten,"  as 
it  was  usually  called,  enjoyed  great  vogue  and  was  reprinted 
several  times  in  the  original  German.  There  were  also  numerous 
editions  in  Latin,  Dutch,  French  and  English.  Some  of  these 
editions  had  added  to  them,  more  or  less  altered,  the  "Kinder- 
buch"  of  Metlinger  and  in  some  this  part  of  the  work  is  attributed 
to  Metlinger,  in  others  it  is  published  without  giving  the  author's 
name. 

The  English  translation  was  first  published  in  1540  and  many 
times  afterward,  even  as  late  as  1 676.  These  English  editions  have 
been  fully  considered  by  Ballantyne.2  He  suggests  that  the 
English  mind  may  have  had  its  attention  directed  towards  the 
perils  of  childbirth  by  the  recent  death  of  Jane  Seymour  whom 
Henry  vin  married  the  day  after  the  beheading  of  Anne  Boleyn, 
which  may  or  may  not  have  led  one  Richard  Jonas  to  translate 
the  Rosegarten.  This  translation  is  now  an  exceedingly  rare  book 
of  which  there  is  a  copy  without  the  plates  in  the  British  Museum. 
Ballantyne  thinks  that  this  was  a  simple  translation  of  "De  Partu 
Hominis,"  most  likely  of  the  1538  edition  published  at  "Paris 
Apud  Joannem  Foucher."  Ballantyne  quotes  a  description 
written  by  Dibdin  in  his  edition  of  Ames'  "Antiquities,"3  after 

1  Ingerslev,  E.  Rosslin's  "Rosegarten,"  etc.,  J.  Obst.  &"  Gynaec.  Brit.  Emp.t  Lond., 
xv,  1,  73,  Jan.  and  Feb.,  1909. 

2  Ballantyne,  J.  W.  The  byrth  of  mankynde,  etc.,  J.  Obst.  er  Gyneac.  Brit.  Emp.t 
Lond.,  x,  297,  Oct.,  1906;  xii,  175,  Oct.,  1907;  xvn,  329,  April,  1910. 

3  Ames.  Antiquities,  in,  563,  1876. 

142 


JONAS  AND  RAYNALDE  143 

the  examination  of  a  perfect  copy  in  "the  richly  stored  library 
of  my  friend  Mr.  Herbert." 

Tbe  Byrtb  oj  Mankynde.  1540.  Quarto.  "The  byrth  of  mankynde 
newly  translated  out  of  Laten  into  Englysshe.  In  the  which  is  entreated 
of  all  suche  thynges  the  which  chaunce  to  women  in  theyr.  labor,  and  all 
suche  infyrmitees  whiche  happen  unto  the  Infantes  after  they  be 
delyuered.  And  also  at  the  latter  ende  or  in  the  thyrde  or  last  boke  is 
entreated  of  the  conception  of  mankynde,  and  howe  manye  wayes  it 
may  be  letted  or  furtheryd,  with  diuers  other  fruytefull  thynges,  as  doth 
appere  in  the  table  before  the  booke.  Cum  priv.  regal,  ad  impr.  sol."  On 
the  back  of  the  title-page  is  a  sort  of  religious  "admonicion  to  the 
reader,"  which  is  followed  by  a  dedication  of  six  pages  "Unto  the  most 
gracious  and  in  all  goodnesse  most  excellent  vertuous  Lady  Quene 
Katheryne  wyfe  and  most  derely  belouyd  spouse  unto  the  most  myghty 
sapient  Christen  prynce  Kynge  henry  the  vin.  Richard  Ionas  wyssheth 
perpetuall  ioye  and  felicyte." 

Dibdin  concludes  his  description  by  stating  that  "at  the  end, 
we  read  this  colophon:  'Imprynted  at  London  by  T.  R.  Anno 
Domini  mcccccxl.'  " 

The  only  knowledge  we  have  of  Richard  Jonas  is  that  he 
was  described  as  "a  certayne  studious  and  diligent  Clarke"  in 
the  prologue  of  the  editions  of  the  work  which  were  augmented 
by  Thomas  Raynalde. 

Wherefore  not  to  come  to  our  purpose,  ye  shal  understand  that 
about  a  thre  or  foure  yeres  past,  a  certayne  studious  and  diligent  clarke, 
at  the  request  and  desyre  of  diuers  honest  and  sad  matrones,  beynge 
of  hys  acquayntaunce,  dyd  translate  out  of  Latin  into  English  a  great 
part  of  thys  boke,  entiteling  it  according  to  the  Latine  inscription  (de 
partu  hominis,  that  is  to  saye:  of  the  byrth  of  mankynd)  which  we  nowe 
do  name  (The  womans  boke)  (for  so  moch  as  the  most  parte  or  well 
neare  all  therein  entreated  of,  doth  concerne  andtouche  onely  women). 
In  whych  hys  translation  he  varied,  or  declyned  nothing  at  al  from 
the  steppes  of  his  Latine  auctor.  Obseruynge  more  fydelytye  in  trans- 
Iatynge,  then  choyse  or  dyscretion  at  that  tyme  in  admyttynge  and 
alowyng  many  th-ynges  in  the  same  Boke,  greately  neadyng  admonityon 
and  wary  aduyse  or  counsell  to  the  readers,  whyche  otherwyse  myghte 
sometymes  use  that  for  a  helpe,  thee  whyche  shoulde  turne  to  a  hynder- 
aunce,  wherefore  I  reuoluyng  and  earnestly  reuysinge  from  top  to  too  ye 
sayd  boke,  and  here  withal  considering  the  manifold  utilite  and  profyte, 
whych  thereby  moughts  ensue  to  all  women  (as  touching  that  purpose) 
yf  it  were  more  narowly  looked  ouer,  and  wyth  a  strayghter  judgement 


i44  PEDIATRICS  OF  THE  PAST 

more  exactly  euery  thing  therein  pondred  and  tryed,  thoughte  my 
labour  and  paynes  shuld  not  be  euyl  employed,  ne  unthankefully 
accepted  and  receaued  of  al  honest,  discrete  and  sege  women.  If  I  after 
good  and  dylygent  perusing  thereof  dyd  correcte  and  amende  soche 
fautes  in  it,  as  semed  worthy  of  the  same,  and  to  aduyse  the  readers 
what  thynges  were  good  or  intollerable  to  be  used,  which  were  daunger- 
ous,  and  which  were  utterly  to  be  eschued.  The  which  thinge  I  haue  not 
only  so  done,  but  ouer  this  haue  ther  unto  adioyned  and  annexed 
dyuers  more  experimented  and  more  familier  medicines. 

The  book  is  dedicated  to  "Quene  Katheryne  wyfe  and  most 
derely  beloved  spouse  unto  the  most  myghty  sapient  Christen 
prynce  Kynge  henry  vin."  The  biographer  of  Raynalde  in  the 
"Dictionary  of  National  Biography"  states  that  it  was  dedicated 
to  Catherine  Parr,  but  Ballantyne  with  apparent  justice  says  that 
it  must  have  been  to  Katherine  Howard,  who  succeeded  Anne  of 
Cleves,  and  who  was  Queen  at  the  time  the  book  was  published. 
Subsequent  editions  omitted  the  dedication,  possibly  owing  to  the 
frequency  with  which  King  Henry  changed  wives. 

As  to  Thomas  Raynalde,  whose  name  appears  spelled  in  various 
ways,  we  know  but  little.  There  was  a  printer  of  the  same  name 
in  London  between  1541  and  1545  and  he  printed  the  first  book. 
Some  have  thought  the  author  to  be  also  the  printer  but  evidently 
that  is  not  the  case  as  Ballantyne  explains  at  some  length.  He 
printed  the  1540  edition  and  likewise  the  1545  and  1552  editions 
but  the  name  appears  in  the  colophons  as  Tho.  Ray. 

Thomas  Raynalde  the  physician  traveled  abroad,  as  may  be 
inferred  from  various  parts  of  his  writings,  and  was  in  Venice  in 
1 56 1  and  also  in  Padua  and  in  Paris.  In  Venice  he  had  printed  a 
book,  which  would  hardly  have  been  the  case  if  he  were  a  printer 
himself.  This  book  was  entitled  "  A  compendius  Declaration  of  the 
Excellent  Virtue  of  a  certain  lately  invented  oile  called  for  the 
worthnis  thereof  oil  imperial  with  the  manner  how  the  same  is  to 
be  used  for  the  benefit  of  mankinde  against  innumerable  diseases 
by  Thomas  Rainald  Doc.  of  Phisick,  Virtate  duce,  comite  for- 
tuna,  Venice  155 1."  This  volume  was  inscribed  "to  his  singular 
friend  Francis  Mery,  Merchant  of  the  City  of  London."  It  is 
related  that  Mery  bought  heavily  of  the  "oile"  which  may  have 
had  much  to  do  with  the  author's  gratitude. 

The  first  edition  of  "The  Byrth  of  Mankynde"  may  be 
regarded  as  a  translation  by  Richard  Jonas.  It  contains  eighty-six 


JONAS  AND  RAYNALDE  145 

numbered  leaves,  is  printed  in  Gothic  type  and  contains  four 
copper-plate  engravings  showing  the  child  in  utero.  Ballantyne 
says: 

I  have  carefully  collated  the  contents  of  this  first  edition  of  the 
Byrth  with  those  of  later  editions.  The  1540  edition  has  its  contents 
divided  into  three  instead  of  four  books;  it  lacks  the  Prologue  to  the 
Women  Readers  which  appears  in  later  editions;  but  it  has  the  dedication 
to  Quene  Katheryne;  it  lacks  also  the  Plates  of  Anatomical  Figures 
which  later  editions  have,  although  it  possesses  the  Birth  Figures 
(indeed,  all  the  editions  have  the  latter). 

In  1545  Thomas  Raynalde  "corrected  and  augmented"  the 
book  so  that  it  was  almost  a  new  work.  It  seems  to  have  had  a 
remarkable  vogue  and  was  reprinted  in  1555, 1560,  1564,  (?),  1565, 
1593,  (?),  1598,  1604,  1613,  1626,  1634,  1654,  and  1676. 

The  1540  edition  by  Jonas  contains  the  second,  third  and 
fourth  books  as  arranged  by  Raynalde  and  also  the  last  chapter  of 
the  first  book.  The  prologue  of  the  Raynalde  editions  is  evidently 
from  the  pen  of  that  worthy. 

The  third  book  of  the  Raynalde  edition,  according  to  Ballan- 
tyne, corresponds  to  chapters  x  and  xi  and  the  whole  of  the 
second  book  of  the  first  edition  of  Jonas.  There  are  some  verbal 
differences,  the  chapter  on  "  unsleepiness  "  is  shorter,  the  one  on 
swelling  of  the  coddes  is  different  and  there  are  two  additional 
short  paragraphs  the  one  "against  the  mother"  and  the  other 
of  short  breath  or  whistling  in  the  throat  and  there  is  an  additional 
sentence  on  infantile  constipation.  In  the  1564  edition  there  is  a 
new  chapter  added  by  some  unknown  writer  about  nursing  infants 
and  how  to  choose  a  good  nurse. 

Now  the  interesting  thing  is  to  see  how  Metlinger's  book 
furnished  pediatric  information  for  such  a  wide  audience.  In  the 
article  on  Metlinger  we  have  seen  how  many  times  it  was  reprinted 
in  German  both  alone  and  in  connection  with  at  least  one  of  the 
pediatric  poems.  When  Roslin  incorporated  it  into  the  Rosegar- 
ten  it  had  a  still  wider  circulation  and  it  was  translated  into 
French,  (the  writer  has  never  seen  a  French  edition.)  When  Jonas 
translated  it  into  English,  and  when  Raynalde  appropriated  the 
translation  with  scant  acknowledgement,  it  must  have  had  a  very 
wide  circulation  considering  how  many  times  it  was  reprinted. 
It  is  interesting  to  speculate  to  what  extent  Metlinger  thus 


146  PEDIATRICS  OF  THE  PAST 

influenced  French  and  English  pediatric  literature.  Did  Phaer 
know  this  translation  of  Metlinger  when  he  wrote  his  book? 

Unquestionably  Phaer  had  seen  the  Jonas  translation  before 
he  wrote  his  book.  The  directions  as  to  choosing  a  wet-nurse  con- 
tain essentially  the  same  information,  and  many  of  the  phrases  are 
identical.  For  example,  Jonas  has  "also  to  eate  of  the  brothe  in  the 
which  is  soden  a  henne  with  cinnamon,  maces,  and  cardamomum 
and  also  the  yowlke  of  an  egge."  This  in  Phaer  reads,  "Also  the 
broth  of  an  olde  cocke,  with  myntes  cinnamone  and  maces." 

But  after  all  Phaer's  indebtedness  to  Jonas  (or  to  Metlinger) 
was  not  great.  Making  due  allowance  for  coincidence  and  each 
taking  the  same  information  from  a  common  source  there  are 
only  eight  chapters  of  Jonas  that  have  been  used  and  most  of 
these  to  but  small  extent.  The  chapter  on  Google  Eyes  is  the 
only  one  which  is  nearly  word  for  word.  A  comparison  may  be 
made.  The  Jonas  version  is  as  follows: 

OF  GOOGLE  EYES  OR  LOKYNGE  A  SQUYNT 

Yf  the  chylde  have  google  eyes  or  that  it  Ioke  a  squynt  then  fyrst  set 
the  cradel  in  such' a  place  that  the  Iyght  maye  come  directelye  and  ryght 
in  the  chyldes  face  neyther  in  the  one  syde  neyther  in  the  other,  neyther 
above  the  heade,  Ieste  it  torne  the  syghte  after  the  Iyght.  Also  marke 
on  whiche  syde  that  the  eyes  do  gogle,  and  let  the  Iyghte  come  unto  it 
on  the  cotrary  syde,  so  to  retorne  the  syght.  And  in  the  nyght  season 
set  a  candell  on  the  contrarye  syde,  so  that  by  this  meane  the  goglynge 
of  the  eyes  may  be  retorned  to  the  ryghte  place.  And  farther  it  shall  be 
good  to  hange  clothes  of  divers  and  freshe  coloures  on  the  contrary  syde 
and  especially  of  the  coloure  of  Iyght  grene  or  yelowe,  for  the  chylde 
shall  have  pleasure  to  beholds  these  strange  coloures  and  in  retornynge 
the  eye  syghte  towarde  suche  thynges  it  shal  be  occasion  to  rectifye 
the  syght  agayne:  and  this  shall  be  sufficient  for  this  tyme  of  the  dyseases 
of  chyldren,  after  they  be  borne  makynge  here  an  ende  of  this  seconde 
boke. 


THOMAS  PHAER 

[1510  7-1560] 
The  Father  of  English  Pediatrics 

THIS  all  but  forgotten,  old  worthy  should  not  be  allowed  to 
pass.  Whatever  its  merits,  the  first  book  on  pediatrics  printed 
in  English  should  not  be  permitted  to  remain  a  curiosity, 
known  only  to  medical  bibliophiles  and  doubtless  not  even  to  many 
of  them,  except  in  a  most  cursory  way.  This  book  is  Phaer's  "Boke 
of  Children,"  originally  published  in  1544(7),  the  first  copy  extant 
bearing  the  date  of  1545.  It  was  printed  along  with  his  translation 
from  the  French  of  the  "Regimen  sanitatis  salerni,"  which  Phaer 
entitled  the  "Regiment  of  Life,"  and  "A  goodly  Bryefe  Treatise 
of  the  Pestylence  with  the  causes,  signs,  and  cure  of  same"  and 
"Declaration  of  the  Veynes  of  Man's  Body,  and  to  what  Dyseases 
and  Infirmities  the  opening  of  every  one  of  them  does  serve." 
Before  examining  his  pediatric  contribution  it  may  be  well 
to  consider  the  man.  The  son  of  Thomas  Phaer  of  Norwich,  and 
Anne  Godier  his  wife,  he  is  supposed  to  have  been  born  in  15 10. 
He  was  educated  at  Oxford  and  went  thence  to  Lincoln's  Inn  where 
he  read  law  and,  as  Wood  says, "  attained  a  considerable  knowledge 
in  the  municipal  laws." 

Phaer  lived  in  a  remarkable  age,  the  prelude  to  the  Golden, 
Elizabethan  Age.  The  strong  rule  of  the  Tudors  had  made  possible 
the  pursuits  of  peace,  and  literature  in  the  English  language  was 
coming  into  its  own.  The  scholastic  shackles,  the  strong  bands  of 
Latin  and  Greek,  were  loosening  and  the  Bible  was  in  the  process  of 
translation  into  the  common  tongue.  Luther  translated  the  Bible 
into  German  and  it  appeared  in  1521;  Tyndale's  New  Testament 
in  English  was  printed  in  1525;  Olivetan's  Bible  in  French  was 
dated  1535,  and  in  the  same  year  Coverdale  finished  the  first 
complete  English  translation.  These  events  must  have  made  a 
deep  impression  on  Phaer,  whose  chief  claim  to  fame  is  the  part 
he  played  in  making  available  in  the  English  tongue  certain 
notable  books. 

147 


The  .xiii.  Bookes 

OFjES^EIVOS. 

The  firft  tweluc  becinge  the 

rtoorfy  of  the  diuine  Toet 
Virgil  Maro,anb  tfje  ftnrfenfy 

ihtfupplemeM  of'  Maphxu*  Vc«»  iu*. 

Tranjlatedinto  Englijh  Verfe  to 

rtjt  fpiQ  tftrtpart  of  tfc  ttntt))&oolie, 

*2  Thorn*  Phaer  efquirr:  anoifpe  reftae 

finifhed,  andnowthcfcCondtimeDcwl/ 

Mfetfl  ft*  t&e  N  lite  of  fttcft  of  art  flm 

<W  fr  PMfrir :  »?  Thonus  Twjtk; 

Doaot  in  Phyfick*. 


f  Imprinted  at  London  by 
JViUiam  H<n»,for  Abraham 

Vcalc,  fctoefltng  in  i&auletf  <f  &urtf> 

ycard  at  the  fignc  of  the  Lambe. 

1584 


Title  page  of  Phaer's  translation  of  the  vEneid. 


THOMAS  PHAER  149 

Phaer's  family  was  evidently  in  easy  circumstances.  His 
grandfather  was  a  knight,  of  the  City  of  London,  and  of  an  old 
Hertfordshire  family.  Due  to  his  position  or  possibly  more  to  his 
writing  two  law  books  in  English,  he  was  made  a  solicitor  in  the 
Court  of  the  Welch  Marches  and  repaired  to  a  house  in  Kilgarran 
or  Cilgerran  in  Pembrokeshire,  where  he  spent  his  days.  His 
contributions  to  the  literature  of  the  law  are  "Natura  Brevium, 
newly  corrected  in  Englishe  with  divers  addicions  of  statutes, 
book  cases,  plees,"  published  in  1535,  and  a"NewBokeof  Presi- 
dentes  in  maner  of  a  register  wherein  is  comprehended  the  very 
trade  of  makyng  all  maner  evydence  and  instruments  of  practyse 
right  commodyous  and  necessary  for  every  man  to  knowe," 
which  appeared  in  1543.  He  gives  his  title  as  "Solicitor  to  Queen 
Mary,  justice  of  the  peace  and  custos  rotulorum  for  the  county  of 
Pembroke." 

Late  in  life,  Phaer  was  granted  an  m.  b.  at  Oxford,  to  be  exact 
on  February  6,  1558-59.  This  gave  him  leave  to  practice,  which  he 
had  been  doing  since  about  1539,  as  he  states  that  for  twenty 
years  he  had  been  practicing  medicine  and  experimenting  with 
poisons  and  their  antidotes.  The  next  month,  on  March  twenty- 
first,  he  was  made  m.  d. 

Phaer's  chief  associations  were  literary;  he  was  a  friend  of 
some  of  the  prominent  writers  of  his  time.  His  friend,  George 
Ferrers,  one  of  the  editors  of  the  Mirror  for  Magistrates,  was 
mentioned  in  his  will  and  asked  to  write  his  epitaph  for  the  stone 
over  his  grave  in  Cilgerran  Church. 

As  with  many  physicians,  he  liked  to  write  verse.  In  1544,  he 
wrote  a  commendatory  poem  for  Peter  Betham's  "Precepts  of 
Warre,"  of  which  the  stanza  lacks  but  two  lines  of  the  rigid  Spen- 
serian, while  the  meter,  form  and  substance  are  so  like  "The 
Faerie  Queene"  (1590),  that  one  wonders  if  the  greater  poet  after 
all  derived  his  sonnets  from  English  models. 

Chyfest  is  peace,  but  yf  by  extremetye 
Thou  be  enforced  to  fyght  for  thyne  owne, 
Learne  here  the  science  and  actes  of  Chyvaldrye, 
PoIIicies,  and  privites  to  many  men  unknowen; 
Whereby  thyne  enemye  may  be  over  throwen ; 
In  such  a  necessitie  shalt  thou  never  finde 
Such  an  other  treasure:  kepe  it  wel  in  minde. 


150  PEDIATRICS  OF  THE  PAST 

In  the  same  year,  Phaer's  "Regiment  of  Life"  was  published, 
but  the  earliest  edition  extant  is  dated  1546.  This  work  had  been 
translated  into  English  in  1528  by  Thomas  Paynell,  who  says: 
"This  boke  techyng  al  people  to  governe  them  in  helthe  is  trans- 
lated out  of  the  Latyne  tongue  in  to  Englyshe."  This  product  of 
the  School  of  Salerno  is  too  well  known  to  need  further  comment. 
Phaer's  translation  went  through  numerous  editions  and  was 
reprinted  as  late  as  1596. 

To  the  Mirror  for  Magistrates,  a  publication  devoted  to  poetry 
of  the  type  that  might  be  described  in  the  words  of  Lowell: 

Such  as  hermits  might  mortify  over  in  caverns, 
Such  as  Crusoe  might  read,  although  there  are  few  so 
Outrageously  cornered  by  fate  as  poor  Crusoe, 

Phaer  contributed  a  poem  entitled  "How  Owen  Glendour 
seduced  by  false  prophecies  took  upon  him  to  be  prince  of  Wales, 
and  was  by  Henry,  Prince  of  England  chased  to  the  mountaynes, 
where  hee  miserably  died  for  lack  of  food,  a.  d.  1401."  A  couple  of 
stanzas  out  of  the  thirty-four  will  suffice,  if  only  to  indicate  how 
closely  Phaer's  verses  resemble  in  form  and  substance  the  much 
later  Spenserian  stanza: 

And  at  the  last:  like  as  the  little  roach, 
Must  eyther  be  eate,  or  Ieape  vpon  the  shore 
When  as  the  hungry  pickerell  doth  approach, 
And  there  finde  death  which  it  escapt  before: 
So  double  death  assaulted  me  so  sore, 
That  eyther  I  must  vnto  mine  enmy  yeelde, 
Or  starve  for  hunger  in  the  barrayn  feelde. 

Here  shame  and  payne  a  while  were  at  a  strife, 
Payne  bade  mee  yeelde,  shame  bade  me  rather  fast; 
The  one  bad  spare,  the  other  bad  spend  my  life, 
But  shame  (shame  have  it)  overcame  at  last: 
Then  hunger  grew,  that  doth  the  stone  wall  brast, 
And  made  me  eat  both  gravel,  durt  and  mud, 
And  last  of  all  my  dung,  my  flesh,  and  bloud. 

Phaer  is  also  supposed  to  have  written  a  ballad  called  "Gad's 
Hill";  indeed  there  is  an  entry  in  the  register  of  the  Stationer's 
Company  in  1558-59,  of  a  ballad  entitled  "On  the  Robbery  at 
Gaddes-Hill."  In  1566,  after  Phaer's  death,  Thomas  Purfoot  was 


THOMAS  PHAER  151 

licensed  to  publish  "Certain  Verses  of  Cupydo  by  M.  Fayre."  A 
copy  of  this  is  not  known  to  be  in  existence.  In  keeping  with  the 
custom  of  the  time,  Phaer's  name  is  variously  spelt  as  Phayer, 
Phayre,  Phaier,  Fayre,  Faire,  Ffaer  and  Ffer.  Phaer's  chief  idea 
seems  to  have  been  the  popularization  of  learning.  Having  in 
mind  the  thought  expressed  by  Sir  Philip  Sidney  in  his  "Apology 
for  Poetry":  "That  no  philosopher's  precepts  can  sooner  make  you 
an  honest  man  than  the  reading  of  Virgil,"  he  applied  himself  to 
the  task  of  translating  the  ^neid  into  English  verse.  This  he 
began  the  ninth  of  May,  1555,  the  first  book  being  completed 
on  the  twenty-fifth  of  the  same  month.  He  worked  rapidly  and 
managed  to  complete  a  book  in  about  twenty  days'  time.  The 
first  seven  books  were  brought  out  by  John  Kingston,  in  1558. 
When  he  finished  the  fifth  book,  May  4,  1556,  he  made  a  note  that 
he  had  escaped  some  accident,  post  periculum  cuius  karmerdini. 
By  April  3,  1560,  he  had  finished  the  ninth  book  and  then  injured 
his  right  hand.  He  died  shortly  after,  in  1560. 

In  1562,  Rowland  Hall,  for  Nicholas  England,  printed  the 
quarto  edition  of  "The  nyne  first  bookes  of  the  Eneidos  of  Virgil 
converted  into  English  Vearse  by  Thomas  Phaer,  doctour  of 
Physicke,  with  so  muche  of  the  tenthe  booke  as  since  his  death 
(1560)  coulde  be  found  in  imperfit  papers  at  his  hime  in  Kilgaran 
Forest  in  Pembrokeshire."  Thomas  Twine  finished  the  work  and 
it  was  published  in  1584;  "now  for  the  second  time  newly  set 
forth  for  the  delite  of  such  as  are  studious  in  Poetrie." 

Of  his  own  work  Phaer  says: 

You  may  therefore  accept  these  translations  as  things  roughly  begun, 
rather  than  polished,  and  where  you  shall  understand  a  fault,  I  desire 
you,  with  silence,  patiently  pass  it,  and,  upon  knowledge  given  to  me, 
I  shall  in  the  next  setting  forth  endeavour  to  reform  it. 

The  critics  of  his  own  age  gave  it  unstinted  praise,  as  well  they 
might,  it  being  the  first  complete  translation  available;  but  the 
fashions  in  verse  change  and  Phaer's  version  finally  ceased  to  be 
reprinted  and  was  replaced  by  Dryden  and  others.  In  the  seven- 
teenth century  Thomas  Fuller  in  his  "History  of  the  Worthies  of 
England"1  states  that  Pits  referred  to  the  Virgil  as  having  been 
translated  magna  gravitate  "which  our  modern  wits  will  render 
with  great  dulness"  Sir  Sidney  Lee  says  that  "Phaer's  translation 

London,  1622. 


152  PEDIATRICS  OF  THE  PAST 

in  fourteen  syllable  rhyming  ballad  metre,  is  often  spirited  and 
fairly  faithful."  As  late  as   19 13,  Brenner  devoted  eighty-three 
octavo  pages  to  Phaer,  mostly  taken  up  with  a  laborious  critical 
examination  of  Phaer's  text.  He  reprinted  the  sixth  book. 
A  short  sample  of  the  translation  will  suffice: 

Nor  nothing  Iesse  this  whyle,  the  Troians  al  in  solempne  gyse 
Did  wayle  Misenus  corps,  and  gave  to  him  their  last  outcries. 
Furst,  cut  in  culpons  great  and  fat  of  sappe  with  pytche  among 
A  stately  pile  they  bylde,  with  tymber  trees,  and  cipers  strong 
(That  dead  mens  treasour  is)  his  gorgeous  arms  also  they  set. 
Some  brought  water  warme,  and  caudrons  boyling  out  they  set. 
The  body  colde  they  washe,  and  preciose  ointments  on  they  powre. 
Lamenting  Ioude  is  made,  than  close  his  Iymmes  in  bed  on  floore 
Ther  couch  with  weeping  teares,  and  purple  weedes  on  him  they 

throw ! 

His  robes,  his  harnes  bright,  and  enseignes  al  that  men  may  know. 
In  mourning  sort,  some  heaue  on  shulders  hie  the  mighty  beere, 
(A  doleful  service  sad)  as  children  do  their  father  deere, 
Behind  them  holding  brondes,   than  flame  vprising,   broad  doth 

spreede 

And  oyles  and  dainties  cast,  and  frankynsens  the  fier  doth  feede. 
When  falne  his  cynders  were,  and  longer  blase  did  not  endure; 
His  reliques  and  remain  of  dust  with  wynes  they  washyd  pure. 
Then  Chorney  his  bones  in  brasen  coffyn  bright  did  close. 
And  sprincling  water  pure,  about  his  mates  thre  tymes  he  goes, 
And  dropps  of  sacryd  dewe  with  Olyue  palmes  on  them  did  shake 
And  compas  blest  them  all,  and  sentence  last  he  sadly  spake. 

In  another  place,2  the  writer  has  printed  a  number  of  interest- 
ing facts  and  criticisms  of  Phaer,  one  or  two  of  which  may  be 
mentioned;  to  wit,  Thomas  Churchyard  (1 520-1 604)  in  his  pref- 
ace to  Skelton's  Works,  1568,  wrote: 

And  Phaer  did  hit  the  pricke 
In  things  he  did  translate. 

In  George  Owen's  description  of  Pembrokeshire,  1603,3  we 
find  the  following  record: 

Thomas  Phaer  doctor  of  phisicke  a  man  honored  for  his  Iearneinge, 
commended  for  his  government  (self  control)  and  beloved  for  his  pleasant 

*  Annals  of  Medical  History,  II,  iv,  334. 

*  Edited  by  Henry  Owen,  1892,  p.  239. 


THOMAS  PHAER 


*53 


naturall  conceptes,  he  chose  Pembrokeshire  for  his  earthlye  place, 
where  he  lived  worshipfully,  and  ended  his  daies  to  the  grieffe  of  all 
good  men,  at  the  fforest  of  Kilgurran  being  his  chosen  seate;  he  trans- 
lated the  Eneidos  of  Virgill,  a  worke  of  now  worthelye  commended, 
though  commended  of  most,  sheweinge  the  author  his  great  skill, 
Iearneinge  and  aptnes  of  nature. 

Of  his  medical  works  the  most  important  in  his  day  was 
"The  Regiment  of  Lyfe,"  in  ours,  the  "Boke  of  ChiIdren.,,  The 


THEREOF 

to  is  aooeo  a 

reatiftofthcpcf;! 

ti'xncctwttttfcboixc\ 

"Wit* 


g^3&B*i 


raxifr 


Title  page  of  "The  Regiment  of  Life*'  translation  by  Thomas  Phaer. 


former,  as  has  already  been  stated,  is  a  translation  of  the  "Regi- 
men Sanitatis  Salerni,"  which  is  too  well  known  to  need  any 
comment  here. 

The  title  page  of  the  1545  edition  is  as  follows:  THE  regi-// 
ment  of  life,  whereun-//  to  is  added  a  //  treatise  of  the  pes-// 
tilence,  with  the  boke  //  of  children,  newly  //  corrected  and  en-// 
Iarged  by  T.  //  Phayre.  //  %*  Anno  1545. 


154  PEDIATRICS  OF  THE  PAST 

Phaer's  translation  made  this  work  available  for  English 
reading  people. 

The  book  on  plague  begins: 

Here  beginneth  a  godly  briefe  treatise  of  the  Pestilence,  with  the 
Causes,  Signes  and  Cures  of  the  same,  composed  and  newly  recognized 
by  Thomas  Phayer,  studious  in  philosophy  and  physike  to  the  ayde, 
comforte,  and  utilitie  of  the  poore. 

The  preface  that  follows  is  good  reading,  but  too  long  to 
quote  here.  He  proceeds  to  give  an  account  of  the  pestilence  and 
"the  four  rootes  or  causes. "  He  is  a  pious  fellow  and  "the  first 
roote  and  superior  cause"  is  the  will  of  God.  This  old  idea  of 
disease  being  the  will  of  God  has  been  and  ever  will  be  the  stum- 
bling block  of  medical  progress.  As  long  as  we  sit  idly  by  and  blame 
God  in  place  of  living  in  the  open,  draining  the  swamps,  killing 
mosquitoes  and  the  like  we  shall  have  with  us  disease  in  plenty. 

"The  second  roote  of  the  pestilence  doth  depende  of  the 
heavenly  constellations."  So  he  blames  Saturn  and  Mars,  the  evil 
planets,  and  gives  no  less  an  authority  than  Marsilius  Ficinus, 
"a  man  of  excellent  knowledge  and  no  less  learning."  Because  of 
Saturn  being  cold: 

Reumes,  of  the  Iepry  called  Elephancia  and  diseases  coming  of  his 
heat,  bringeth  forth  fevers,  pestilencial  spitting  of  blood,  water  under 
the  midriff  and  the  pleuresy  ...  A  provident  physicion  among  many 
other  things  ought  to  consider  the  entring  of  the  sun  into  Aires  .  .  . 
[which]  passeth  all  the  entrings  of  the  sunne  into  any  other  sign. 

The  third  roote  or  cause  beeinge  inferiuor,  is  the  stinche  and  filthy 
savors  that  corrupt  the  air. 

The  fourth  roote  is,  the  abuse  of  things  not  natural,  that  is  to  wit, 
of  meate,  and  drinke,  of  slepe  and  watching,  of  labour  and  ease,  of 
fulness  and  emptynes,  of  the  passions,  of  the  minde,  and  of  the  immoder- 
ate use  of  lechery,  for  the  excess  of  all  these  things  be  almost  the  chiefe 
occasion  of  all  sutch  diseases  as  raygne  among  us  now  adays. 

Prescriptions  are  given  for  pills  against  the  pestilence, 
"drinkes,"  "a  very  good  preservative,  for  the  common  people 
ready  at  all  times  and  of  small  cost,"  and  "another  singular 
remedy  preservative  for  riche  men  and  delycate  of  complexion." 
The  sixteenth  century  recipes  need  not  be  given ;  one  laughs  at 
them,  perhaps,  but  the  present-day  medical  writings  contain  much 
that  will  be  regarded  as  very  strange  a  hundred  years  hence. 


THOMAS  PHAER  155 

He  has  many  remedies  and  advises  bleeding  twice  and  various 
other  things  common  at  the  time.  He  gives  the  sound  advice 
"wherein  if  you  are  doubtful,  take  ye  counsel  of  some  good  experte 
physicion." 

Various  external  applications  are  advised;  a  curious  one  is  as 
follows : 

Or  take  a  cocke  and  pull  the  fether  of,  about  his  fundament,  and  put 
a  little  salt  in  it,  and  set  the  fundament  upon  ye  said  botch,  keeping  him 
on  a  good  whyle  stopping  many  times  his  byll,  that  his  breth  may  be 
retayned  and  let  him  blow  again.  And  if  the  cocke  dye  it  shal  be  good 
to  take  another  yong  cocke,  and  splitte  it  quick  asunder,  and  lay  it  on 
the  botch. 

He  closes  his  little  tract  with  a  chapter  on  the  care  of  carbun- 
cles and  the  pestilence  called  anthrax,  winding  up: 

I  could  declare  many  other  remedies  but  I  set  them  that  have  been 
often  proved,  and  that  be  most  easy,  for  to  get  at  neede,  desiring  all 
them  that  shall  use  these  my  simple  labours,  to  accept  my  goodwil 
unto  the  best,  and  to  pray  to  God  almighty  for  his  grace,  unto  whom 
onely  be  all  Iaude,  glory,  and  honor,  world  without  end.  Amen. 

The  next  treatise  is  "A  declaration  of  the  Veyns  in  mans  body, 
and  to  what  diseases  and  infirmytyes  the  opening  of  every  one 
of  them  do  serve." 

"  It  is  not  unknowen  to  any  which  have  seen  anathomies,  howe 
there  be  in  a  mans  body  two  kyndes  of  Veines,  general  and 
special."  There  follows  a  short  account  of  the  veins  of  the  arm,  the 
technique  of  bleeding  and  the  uses  of  opening  the  special  veins. 
The  extreme  special  action  of  opening  some  of  these  as  given  by 
Phaer,  suggests  the  selective  action  of  bacteria.  A  recent  article 
tells  of  a  streptococcus  which  would  always  cause  an  inflammation 
of  the  left  facial  nerve.  Bearing  this  in  mind,  read  the  following 
and  only  quotation: 

The  two  veines  in  the  middle  Toe,  are  good  against  the  Scrophules, 
and  diseases  of  the  face,  spots,  rednes,  and  pimples,  watring  of  the  eyes, 
cankeres  and  knobbes,  &  against  the  stopping  of  the  floures.  The  veine 
on  the  left  ioynt  in  the  great  Toe,  is  good  against  Ophthalmia  of  the  eies, 
spottes  of  the  face  and  the  Iegges,  ytch,  and  vlcers  of  the  euyll  complex- 
ion, and  purgeth  superfluityes  of  the  matryce.  Thus  much  I  haue 
declared  of  the  vtilitie  of  veines. 


156  PEDIATRICS  OF  THE  PAST 

Phaer's  most  important  contribution,  from  a  medical  stand- 
point, is  his  little  book  on  the  diseases  of  children.  He  recognized 
the  importance  of  pediatrics,  not  as  a  speciality,  as  that  was  to 
come  centuries  later,  but  as  an  especialty,  as  it  were,  as  a  branch 
of  medical  learning  almost,  if  not  altogether,  neglected.  The 
knowledge  that  it  was  possible  to  prevent  and  cure  disease  in 
early  life  and  the  authorship  of  the  first  book  in  English  on 


€l)ebofccof 

cljtltwn* 

Ij©bcgyflatre*t?fc 

of  t  cure  of  cfjtltyt* 
itOjouioe  feme  c%* 
'pcment^tDefljoutb 
declare  (omtobat  of 
tfjcpji..cipl«»a0of 
tfcc  generation*  tlje 

^  -~^„  befits  tn  tlje toomb» 

tr?c  trmc  of  pjtoccbvnge  ,  tbc  mancr  of 
tfjcb^jtljctljc  bpntvngeof  tbenaupl, 
fettpngs  of  ttpc  members,  lawatojpcs. 
btietion0  .  toatbmgc0>an&  cntreatc* 
wentc0  »tottl)  tl?c  critcumfiaunee0Of 
tftcfc  f  manpotl)cr:trbtcb  tf  3  Ojoulte 
refcrfc  tn  particle*,*  woutoc  rcqttfte 
botb a  longer rp mc.ano encreafe  into  a 
St  eater  tool  umc.25iufo;afmacr;  aetye 
moaoftljcfe  tijmgc0  arc  &cr?tmce 
tnan  t  f  eQ  ,fome  pertaining  onlp  to  ttyz 
OttUi  of  a  itubkppfCaOmr  Tox  ric  reus? 

roice 

First  page  of  Thomas  Phaer's  book. 


the  subject,  whatever  its  merits,  are  sufficient  to  win  him  the 
title  of  the  "  Father  of  English  Pediatrics." 

[See  also  Jonas  and  Raynalde.] 

The  spelling  is  retained  as  in  the  original.  After  the  over- 
scored  vowels  insert  the  letter  morn,  for  example  intet  =  intent. 
The  final  e  has  been  added  to  y  to  make  it  easier  for  the  reader 
instead  of  the  minute  e  over  the  y  almost  like  a  diacritic  mark 
used  in  the  old  printing. 


THOMAS  PHAER  157 

The  Boke  of  Children 

To  begyn  a  treatyse  of  ye  cure  of  childre,  it  shoulde  seme  expedient, 
that  we  should  declare  somwhat  of  the  principles,  as  of  the  generacion, 
the  beyng  in  the  womb,  the  tyme  of  procedynge,  the  maner  of  the 
byrthe,  the  byndynge  of  the  navyl,  settyinge  of  the  members,  Iavatoryes, 
unctions,  swathinges,  and  entreatementes,  with  the  cyrcumstaunces  of 
these  &  many  other:  which  if  I  shoulde  reherse  in  particles,  it  woulde 
requyre  both  a  longer  tyme,  and  encrease  into  a  greater  volume.  But 
forasmuch  as  the  most  of  these  thinges  are  very  rite  &  manifest,  some 
pertainyng  only  to  the  office  of  a  midwyfe,  other  for  the  reverence  of 
the  matter  not  mete  to  be  disclosed  to  every  vyle  person:  I  entende 
in  this  booke  to  let  them  all  passe,  and  to  treat  onely  of  the  thinges 
necessary,  as  to  remove  the  sicknesses,  wherewith  the  tender  babes  are 
oftetimes  afflicted,  and  desolate  of  remedye,  for  so  muche  as  manye 
doe  suppose  that  ther  is  no  cure  to  be  ministred  unto  the,  by  reason  of 
theyr  weakenes.  And  by  that  vayne  opinion,  yea  rather  by  a  foolishe 
feare,  they  forsake  manye  that  myghte  be  well  recovered,  as  it  shall 
appeare  by  the  grace  of  god  hereafter,  in  thys  Iytle  treatyse,  when  we 
come  to  declaracion  of  the  medicines.  In  the  meane  season  for  confinitye 
of  the  matter,  I  entend  to  write  somewhat  of  ye  nource,  and  of  the  milke, 
with  the  qualityes,  &  complexions  of  ye  same,  for  in  that  cosisteth  the 
chief  point  and  summe,  not  only  of  ye  mayntenaunce  of  health,  but  also 
of  the  fourmyng  or  infectyng  eyther  of  the  wytte,  or  maners,  as  the 
Poet  Vergyl  when  he  would  describe  an  uncurteys  churlysh,  &  a  rude 
condishioned  tyraunt,  dydde  attribute  the  faute  unto  the  gyver  of  the 
mylke,  as  in  saying  thus.4 

Nee  tibi  diua  parens,  generis  nee  Dardanus  author, 

Perfide,  sed  duris  genuit  te  cautibus  horrens  Caucasus,  hircane- 
aeque  admorunt  vbera  tigres. 

For  that  divine  Poet  being  throughly  expert  in  ye  priuities  of  nature, 
onderstode  ryght  wel  how  great  an  alteracion  every  thynge  taketh  of 
the  humoure,  by  the  whyche  it  hath  his  alymente  and  nourishinge  in 
the  youthe:  whiche  thynge  also  was  considred  &  alleged  of  many  wyse 
Philosophers:  Plato,  Theophrastus,  Xenophon,  Aristotle,  and  Plinie, 
who  dydde  all  ascribe  unto  the  nourcement  as  moch  effect  or  more,  as 
to  the  generacyon. 

And  Phauorinus  the  Philosopher  (as  wryteth  Aulus  gelius)  affirmeth 
if  ye  Iambes  be  nouryshed  with  ye  milke  of  goates,  they  shall  have 
course  wolle,  like  the  heare  of  goates:  and  yf  kiddes  in  Iyke  maner  sucke 

4  The  early  reference  to  Virgil  shows  how  Phaer's  mind  was  inclined;  doubtless 
he  was  thinking  of  translating  the  divine  poet  into  English  verse,  a  fact  which  he  well 
nigh  accomplished  before  his  death.  (See  biographical  note  on  his  life.) 


158  PEDIATRICS  OF  THE  PAST 

upo  shepe,  ye  heare  of  them  shalbe  soft  Iyke  wolle.5  Wherby  it  doth 
appeare,  that  the  mylke  and  nouryshyng  hath  a  marveylous  effecte  in 
chaunging  the  complexio,  as  we  se  likewise  in  herbes  and  in  plantes,  for 
let  the  seed  or  ympes  be  never  so  good  &  pure,  yet  yf  they  be  put  into 
an  unkynde  earth,  or  watred  with  a  noughty  and  unholesome  humour, 
either  they  come  not  up  at  al,  or  els  they  wyll  degenerat  and  turne  out  of 
theyr  kinde,  so  that  scarce  it  may  appeare  fro  whence  they  have  ben 
take:  accordig  to  ye  verse. 

Pomaque  degenerant,  succos  oblita  priores.  Wherfore  as  it  is  agreing 
to  nature,  so  is  it  also  necessary  &  comly  for  the  own  mother  to  nourse 
the  own  child.6  Whiche  if  it  maye  be  done,  it  shal  be  most  comendable 
and  holsome,  yf  not  ye  must  be  well  advised  in  taking  of  a  nource,  not 
of  yll  complexion  and  of  worse  maners :  but  such  as  shal  be  sobre,  honeste 
and  chaste,  well  fourmed,  amyable  and  chearefull,  so  that  she  may 
accustome  the  infant  unto  myrth,  no  dronkard,  vycyous  nor  sluttysshe, 
for  suche  corruptethe  the  nature  of  the  chylde. 

But  an  honest  woman  (suche  as  had  a  man  chyld  last  afore),  is 
best  not  within  two  monethes  after  her  delyveraunce,  nor  approchyng 
nere  unto  her  time  againe.  These  things  oughte  to  be  cosidred  of  every 
wyse  person,  that  wyll  set  theyr  children  out  to  nource.  Moreover,  it 
is  good  to  Ioke  upon  the  milke,  and  to  se  whether  it  be  thicke  &  grosse, 
or  to  moch  thinne  and  watrye,  blackysshe  or  blewe,  or  enclynyng  to 
rednesse  or  yelowe,  for  all  suche  are  unnaturall  and  evyll.  Likewise 
whe  ye  taste  it  in  your  mouthe,  yf  it  be  eyther  bytter,  salte,  or  soure, 
ye  may  wel  perceyve  it  is  unholsome. 

That  milke  is  good,  that  is  whyte  and  sweete,  and  when  ye  droppe 
it  on  your  nayle,  and  do  move  your  finger,  neyther  fleteth  abrod  at 
every  stering,  nor  wyll  hange  faste  upon  your  naile,  whe  ye  turne  it 
downeward,  but  that  whyche  is  betwene  bothe  is  beste. 

Somtime  it  chaunceth  that  the  milke  wasteth,  so  that  ye  nource 
can  not  have  sufficiente  to  susteine  the  child,  for  the  which  I  wil  declare 
remedies  leaving  out  the  causes  for  brevitie  of  time. 

5  This  old  idea  concerning  the  food,  carried  over  in  the  German  proverb:  Mann 

ist  was  er  isst  (Man  is  what  he  eats),  runs  through  all  the  early  writings  and  some 

later  ones  as  well.  An  interesting  quotation  on  this  subject  is  from  Thomas  Muffet's 

(1553-1604)  book  on  "Health  Improvement"  (1584): 

Nay  (which  is  more)  no  man  can  justify  doubt,  that  a  child's  mind  is  answerable  to  his  nurses 
milk  and  manners;  for  what  made  Jupiter  and  Aegystus  so  lecherous,  but  that  they  were  chiefly  fed 
with  goats  milk?  What  made  Romulus  and  Polyphemus  so  cruel  but  that  they  were  nursed  by 
she-wolves?  What  made  Pelias  (Tyrus  and  Neptunes  son)  so  brutish  but  that  he  was  nursed  by  an 
unhappy  mare.  Is  it  any  marvel  also,  that  Giles,  the  Abbot  (as  the  Saint-Register  writeth)  con- 
tinued so  long  the  love  of  a  solitary  life  in  woods  and  deserts,  when  three  years  together  he  suckt  a 
doe?  What  made  Dr.  Cajus  in  his  last  sickness  so  peevish  and  so  full  of  frees  at  Cambridge,  when  he 
suckt  one  woman  (Whom  I  spare  the  name)  forward  of  conditions  and  of  bad  diet;  and  contrariwise 
so  quiet  and  well  when  he  suckt  another  of  a  contrary  disposition. 

6  The  importance  of  maternal  nursing  and  the  choice  of  a  wet-nurse  are  two 
important  things  which  Phaer  treats  in  a  most  commendable  manner.  The  nail  test  for 
milk  is  that  of  Soranus  of  Ephesus  and  it  may  be  that  Soranus  got  it  from  someone  else. 


THOMAS  PHAER  159 

REMEDIES  APPROPRIATE  TO  YE  ENCREASYNG  OF  MYLKE  IN 

THE  BRESTES 

Pasneppe  rootes,  and  fenelle  rootes  sodde  in  broth  of  chickens,  & 
afterward  eaten  with  a  Iitle  fresshe  butter,  maketh  encrease  of  mylke 
within  the  brestes. 

AN  OTHER 

The  pouder  of  earth wormes  dryed  and  dronken  in  the  broth  of 
a  neates  tonge,  is  a  singuler  experiment  for  ye  same  intent. 

Also  the  broth  of  an  olde  cocke,  with  myntes,  cynamone  and  maces. 

Rice  also  sodden  in  cowes  mylke,  with  the  cromes  of  white  breed, 
fenell  seede  in  pouder,  and  a  Iitle  sugre  is  excedyng  good. 

AN  OTHER  GOOD  MEDICINE  FOR  THE  SAME 

Take  Christall,  and  make  it  in  fyne  pouder,  and  myxe  it  with  as 
moche  fenell  seede  and  suger,  and  use  to  drinke  it  warme  with  a  Iitle 
wyne. 

A  PLAYSTER  FOR  THE  ENCREASE  OF  MYLKE 

Take  fenell  and  hoorehounde,  of  everyone  two  handefulles,  anys  seede 
foure  drammes,  Saffron  a  scruple  in  poudre,  swete  butter  thre  ounces, 
seeth  them  in  water,  and  make  a  playster  to  be  Iayed  upon  the  nurces 
brestes. 

These  thynges  have  propertie  to  augment  the  mylke,  dylle,  Anyse 
seede,  fenelle,  christal,  horehounde,  fresh  chese,  honye,  Iettuse,  beetes, 
myntes,  carette  rootes,  parsneppees,  the  dugges  or  ydder  of  a  cowe  or  a 
shepe,  gootes  milke,  blaunched  almondes,  ryce  porrigge,  a  cowes  toung 
dryed  and  made  in  pouder,  poched  egges,  saffron,  and  the  iuce  of  rosted 
veale  dronken.7 

Thus  moche  of  the  nource,  and  of  the  mylke:  nowe  wil  I  declare  the 
infirmities  of  children. 

Althoughe  (as  afhrmeth  Plinie),  there  be  innumerable  passions 
&  diseases,  wherunto  the  bodye  of  man  is  subiecte,  and  as  well  maye 
7  The  search  for  galactagogues  has  been  a  quest  of  all  ages;  the  fountain  of  youth, 
the  alchemist's  gold,  the  golden  fleece  of  Jason,  have  temporarily  been  withdrawn  from 
the  scene,  but  the  quest  of  a  good  milk  stimulant  is  still  with  us.  The  use  of  dugs  and 
udders  suggests  our  organic  therapy.  In  a  delightful  play  of  yesterday,  "Peaceful 
Valley,"  the  inimitable  Sol  Smith  Russell  used  to  tell  how,  in  his  childhood,  he  cried 
for  the  moon.  His  mother,  a  wise  woman,  would  pull  down  the  blind  and  give  him  a 
big  round  soda  cracker  and  he  was  satisfied.  The  early  physicians  and,  alas,  those  of 
today,  often  use  the  same  method.  If  they  want  a  therapeutic  agent  and  have  it  not 
they  use  something  and  imagine  they  have  it.  Will  it  ever  happen  that  Veritas  or 
Veritas  nos  liberabit  will  be  written  in  our  hearts  as  well  as  on  the  college  shields? 


160  PEDIATRICS  OF  THE  PAST 

chaunce  in  the  yonge  as  in  the  older  Yet  for  most  commonly  the  tender 
age  of  children  is  chefely  vered  &  greued  with  these  diseases  folowyng. 

Aposteme  of  the  brayne. 

Swellyng  of  the  heed. 

Scalles  of  the  heed. 

Watchyng  out  of  measure. 

Terrible  dreames. 

The  fallyng  evill. 

The  palseye. 

Crampe. 

Styfnesse  of  Iymmes. 

Bloodshoten  eyes. 

Watryng  eyes. 

Scabbynesse  and  ytche. 

Diseases  in  the  eares. 

Pesyng  out  of  measure. 

Bredyng  of  teeth. 

Canker  in  the  mouth. 

Quynsye,  or  swellyng  of  throte. 

Coughe. 

Sreaytnesse  of  wynde. 

Feblenesse  of  the  stomacke  &  vomiting. 

Yeaxyng  or  hycket. 

Colyke  and  rumblyng  in  the  guttes. 

Fluxe  of  the  belly. 

Stoppyng  of  the  bellye. 

Wormes. 

Swellyng  of  the  navill. 

The  stone. 

Pyssyng  in  bedde. 

Brustynge. 

Fallyng  of  the  skynne. 

Chafyng  of  the  skynne. 

Small  pockes  and  measels. 

Fevers. 

Swellyng  of  the  coddes. 

Sacer  ignis  or  chingles. 

Burnyng  and  scaldyng. 

Kybbes. 

Consumpcion. 

Leanenesse. 

Gogle  eyes. 


THOMAS  PHAER  161 

OF  APOSTEMES  OF  THE  BRAYNE 

In  the  fylme  that  covereth  the  brayne  chaunceth  often  tymes 
apostemacion  &  swellynge,  eyther  of  to  moche  crying  of  ye  chylde,  or 
by  reason  of  the  mylke  immoderatelye  hote,  or  excesse  of  heate  in 
the  bloode,  or  of  colde  fleume,  and  is  knowen  by  these  sygnes.8 

Yf  it  be  of  hote  matter,  the  heed  of  the  chylde  is  unnaturally  swollen, 
redde,  and  hote  in  the  feelyng:  if  it  come  of  colde  matter,  it  is  somwhat 
swollen,  pale  and  colde  in  the  touchyng,  but  in  bothe  cases  the  chylde 
can  not  reste,  and  is  ever  Iothe  to  have  hys  heed  touched,  cryeth  and 
vexeth  it  selfe,  as  it  were  in  a  frenesye. 

REMEDYE 

Make  a  bath  of  mallowes,  camomylle,  and  Iyllyes  sodden  with 
a  shepes  heed,  tyll  the  bones  fall,  and  with  a  spong  or  soft  cloutes,  al 
so  bath  the  head  of  the  childe  in  a  colde  aposteme,  with  the  broth  hote 
as  maye  be  suffered,  but  in  a  hote  matter  wete  the  broth  Iuke  warme,  or 
in  the  cooling,  &  after  the  bathe,  set  on  a  playster,  thus. 

A  PLAYSTRE 

Take  fenugreke,  camomill,  wormwood,  of  every  one  an  handfull, 
seethe  them  in  a  close  vessell,  till  the  thyrde  parte  be  consumed,  then 
stampe  the  in  a  mortar,  and  stirre  them,  to  the  which  ye  shall  put  of 
the  same  brothe  againe  ynoughe  to  make  a  plaister,  with  a  Iitle  beane 
floure,  yolkes  of  egges  &  saffro,  adding  to  them  fresh  butter  or  duckes 
grese  sufficiente,  &  applye  it.  In  a  cold  matter  Iette  it  lye  a  day:  but 
in  a  hote  cause  ye  muste  remove  it  every  five  houres. 

OF  SWELLYNG  OF  THE  HEED 

Inflation  or  swellynge  of  the  heed,  cometh  of  a  wyndye  matter, 
gathered  betwene  the  skynne  and  the  fleshe,  and  sometyme  betwene 
the  fleshe  and  the  boones  of  the  sculle,  the  tokens  whereof  are  manifest 
ynoughe  to  the  syght,  by  the  swellyng  or  puffinge  up,  and  pressed  with 
ye  finger,  there  remayneth  a  prynte,  whyche  is  a  sygne  of  wynde  and 
viscous  humours,  ye  shall  heale  it  thus.9 

8  Meningitis  was  not  very  carefully  studied  in  the  early  days.  It  came,  it  killed 
or  maimed,  occasionally  one  recovered  from  it,  but  not  sufficiently  often  to  arouse 
much  enthusiasm  in  the  physician.  Curiously,  Phaer  does  not  give  a  long  list  of 
remedies,  which  is  usually  the  case  with  medical  writers  when  dealing  with  a  disease 
which  is  not  affected  by  the  therapy  of  the  period. 

9  This  is  evidently  edema  of  the  scalp,  which  in  infancy  arises  from  many  causes. 
The  remedy  of  greasing  a  tensely  stretched  skin  is,  of  course,  good  practice,  but  the 
rest  of  the  recommendation  is  camouflage. 


162  PEDIATRICS  OF  THE  PAST 

REMEDYE 

Fyrst  let  the  nourse  avoide  al  thynges  that  engendre  wynd,  salt 
or  slymy  humours,  as  beanes,  peaso,  eles,  sammon,  salt-fysshe,  and  Iyke: 
then  make  a  playster  to  the  chyldes  heed,  after  this  fashion. 

Take  an  handful  of  fenel,  smallache  and  dylle,  and  seeth  them  in 
water  in  a  close  vessel,  afterwarde  stampe  them,  and  with  a  Iytle  Cumyn, 
and  oyle  of  bytter  almondes,  make  it  up,  and  Iaye  it  often  to  the  childes 
heed,  warme.  In  defaulte  of  oyle  of  almons  take  gosegrese,  adding  a 
Iitle  vinegre.  And  it  is  good  to  bathe  the  place  with  a  softe  cloute,  or  a 
sponge  in  the  broth  of  these  herbes :  Rue,  tyme,  maiorym,  hysope,  fenell, 
dylle,  comyne,  sal  nitre,  myntes,  radysh  rotes,  rocket,  or  some  of  them, 
ever  takyng  heede,  that  there  droppe  no  porcion  of  the  medicines  in  the 
babes  eyes,  mouthe,  or  eares. 

SCALLES  OF  THE  HEADE 

The  heades  of  chyldre  are  oftetymes  ulcered,  &  scalled,  as  wel  when 
they  sucke,  and  the  most  commonly  by  reason  of  sharpe  milke,  as  also 
when  they  have  bene  weaned,  &  can  go  aloone.  Sometimes  it  happeneth 
of  an  evil  complexion  of  humours  by  eatyng  of  rawe  frute,  or  other 
evill  meates,  and  sometyme  by  Ionge  continuynge  in  the  sonne,  many 
tymes  by  dropping  of  restye  bacon,  or  of  salte  beefe  on  theyr  bare  heades. 

Other  whyles  they  be  so  borne  out  of  theyr  mothers  wombe,  and 
in  al  these  is  no  greate  difficultie  til  the  heere  be  growen :  but  after  that, 
they  requyre  a  greater  cure  and  a  conning  hand,  notwithstandynge 
as  God  shall  gyve  me  grace,  here  shal  be  sayde  remedyes  for  the  cure  of 
them,  such  as  have  ben  often  tymes  approved :  wherein  I  have  entended 
to  omyt  the  disputacions  of  the  dyfference  of  scalles,  and  the  humours 
whereof  they  do  proceade,  and  wyl  go  strayght  to  the  composicion  of 
medicynes,  folowyng  the  good  experyence,  here  ensuynge. 

REMEDYES  FOR  SCALLES 

If  ye  se  the  scalles  Iyke  the  shelles  of  oysters,  blacke  and  drye, 
cleavinge  upon  the  skynne,  one  within  an  other,  ye  maye  make  a  fomen- 
tacion  of  hoote  and  moyste  herbes,  as  fenugreke,  holy  hocke,  beares 
breache,  Iyneseede,  and  suche  other,  sodden  al  or  some  of  them  in  the 
brothe  of  netes  feete,  and  so  to  bathe  the  sores,  and  after  that  applye 
a  soft  plaistre  of  the  same  herbes,  with  gose  grese  or  butter,  usynge  thys 
styll,  tyl  ye  se  the  scabbe  removed,  and  then  wasshe  it  with  thy  iuce 
of  horehound,  smallach,  and  betony,  sodden  togither  in  wyne,  and  after 
the  wasshyng  put  upo  it  pouder  of  myrre,  aloes,  and  frankensence,  or 
holde  his  heed  over  a  chafyngdisshe  of  coles  wherin  ye  shal  put  franken- 


THOMAS  PHAER  163 

sence  and  saunders  in  pouder.10  But  yf  ye  se  the  scabbes  be  verye 
sore  and  mattrye,  wyth  great  payne,  &  burnynge  of  the  heede,  ye  shall 
make  an  oyntment  to  coole  the  matter  thus. 


AN  OYNTMENT  TO  COOLE  THE  BURNYNGE  OF  A  FORE  HEADE 

Take  white  Ieade  and  Iytarge,  of  every  one.  v.  drammes,  lye  made  of 
the  asshes  of  a  vyne  iii.  drammes,  oyle  of  roses,  an  ounce,  waxe,  an  ounce, 
melte  the  waxe  fyrste,  than  putte  to  the  oyle  and  lye,  with  the  reste,  and 
in  the  ende  ii.  yolkes  of  egges,  make  an  oyntmet,  and  Iaye  it  to  the  head. 
Thys  is  the  composicion  of  Rasis  [Rhazes].11 

AN  OTHER  OYNTMENT  SINGULER  FOR  THE  SAME  POURPOSE 

Take  betony,  grounswel,  plantayne,  fumytorie,  and  dayses,  of  everye 
one  Iyke  moche,  stampe  them,  and  myngle  them  with  a  pounde  of 
fresshe  s wines  grece,  and  Iette  them  stand  closed  in  a  moyst  place, 
viii.  dayes,  to  putrify,  tha  frye  them  in  a  panne,  and  straine  them  into  a 
cleane  vessel  and  ye  shal  have  a  grene  ointment  of  a  singuler  operacio 
for  the  sayd  dysease,  and  to  quenche  all  unkind  heates  of  the  bodye. 

Also  ye  must  use  to  shave  the  head,  what  so  ever  thiges  ye  doe 
Iai  unto  it.  If  there  Iacketh  the  cleansig  of  the  sores,  and  the  chylde 
weaned,  ye  shal  doe  wel  to  make  an  oyntment  of  a  Iytle  turpentyne, 
bulles  gall,  and  hony,  and  lay  upon  the  sores. 

Also  it  is  proved,  that  the  uryne  of  a  bulle,  is  a  singuler  remedy  to 
mudifie  the  sores,  and  to  Ioce  the  heares  by  the  rootes,  without  any 
peyne  or  pille. 

The  iuyce  also  of  morel,  [night  shade]  daysye  leaves  and  groundswel 
fryed  with  grece  and  made  in  an  oyntmente,  cooleth  al  unkynde  heates, 
and  pustles,  of  the  heade. 

10  The  soundness  of  this  is  apparent.  First  the  scales  were  softened  by  poultices 
and  ointment,  then  the  head  was  washed  with  wine  (Oh  saints  and  sinners  of  Wester- 
ville!)  and  astringents;  the  antiseptic  action  of  the  dilute  alcohol  was  of  course, 
effective,  just  as  today,  or  rather  yesterday,  we  used  a  twenty-five  to  fifty  per  cent 
alcohol  lotion,  no  longer  available  for  tender-skinned  infants,  as  the  worthies  referred 
to  in  the  above  parenthesis  have  insisted  on  the  addition  of  noxious  and  oft  times 
irritating  agents.  Local  applications  of  aloes  and  frankincense  have  passed  and  myrrh 
has  almost  passed  with  them,  and  when  it  does,  an  effective,  pleasant  remedy  for  the 
condition  in  question  leaves  us.  The  use  of  fumigations  with  frankincense  and  saunders 
is  a  thing  of  the  past,  but  it  was  only  yesterday  that  calomel  was  used  in  this  manner. 

11  The  use  of  lead  plaster  as  a  healing  agent  has  practically  disappeared  except 
among  physicians  of  the  old  school.  The  modern  antiseptics  and  the  fear,  certainly 
much  exaggerated,  of  lead  poisoning,  have  hastened  the  exit  of  what  was  once  a 
favorite  and  effective  therapeutic  agent. 


1 64  PEDIATRICS  OF  THE  PAST 

Here  is  to  be  noted,  that  durynge  thys  disease  in  a  suckynge  chylde, 
the  nourse  must  avoyde  al  salt,  and  sower  meates  that  engeder  cholere, 
as  mustarde,  vinegre,  and  such:  and  al  maner  frutes,  (excepte  a  pome- 
granate) and  she  muste  abstayne  in  thys  case,  bothe  from  egges,  and 
from  other  kynde  of  white  meates  in  general,  and  above  al  she  may 
eate  no  dates,  figges,  nor  purcelane,  for  many  holde  opynion  that  puree - 
lane  hath  an  evyll  propertye  to  breede  scabbes  and  ulcers  in  the  head.12 
Moreover  the  childes  head  may  not  be  kept  to  hote,  for  that  is  oftentimes 
the  cause  of  thys  disease. 

Sometymes  it  chaunceth  ye  there  breadeth  in  the  head  of  chyldren 
as  it  were  Iitle  wartes  or  knobbes  somewhat  hard,  and  can  not  be 
resolved  by  the  said  medicines.  Wherfore  whe  ye  se  that  none  other 
thyng  wyll  healpe,  ye  shall  make  a  good  oyntment  to  remove  it,  in 
maner  as  herafter  is  declared. 

AN    EXCELLENT  REMEDY  FOR  WARTES  OR  KNOBBES  OF  THE  HEADE 

Take  Iytarge  and  whyte  lead,  of  eche  a  like  quantitie,  brymstome 
&  quicke  sylver  quenched  with  spittle,  of  eche  a  Iesse  quantity,  twise 
as  moch  oile  of  roses,  and  a  sponefulle  or  .ii.  of  vinegre,  mixe  them  al- 
togither,  on  a  marble,  til  they  be  an  oyntment,  and  lay  it  on  the  head,  & 
when  it  hath  ben  dry  an  houre  or.  ii.  wasshe  it  of,  with  water,  wherin 
was  sodde  maiorym,  savery  and  mints,  use  it  thus  twyse  a  daye,  morn- 
inge  and  evenynge,  tylle  ye  se  it  hole.  This  thyng  is  also  good  in  al 
the  other  kind  of  scalles. 

OF  WATCHYNG  OUT  OF  MEASURE 

Slepe  is  the  nouryshement  and  foode  of  a  suckyng  chylde,  and  as 
much  requisite  as  the  very  tete,  wherfore  wha  it  is  deprived  of  the 
naturall  reste,  all  the  hole  body  falleth  in  distemper,  cruditie  and  weake- 
nes,  it  procedeth  commonly  by  corrupcion  of  the  mylke,  or  to  muche 
aboundaunce  which  overladeth  the  stomake,  &  for  Iacke  of  good  dygestyon, 
vapours  and  fumes  aryse  into  the  head,  and  infect  the  braine,  by  reason 
wherof  the  childe  cannot  slepe,  but  turneth  and  vexeth  it  selfe  wyth 
crying.  Therefore  it  shall  bee  good  to  provoke  it  to  a  naturall  slepe 
thus,  accordyng  to  Rasis  [Rhazes]. 

Annoynte  the  foreheade  and  temples  of  the  chylde,  wyth  oyle  of 
vyolleets  and  vineger,  puttynge  a  droppe  or  two  in  the  nosethrylles, 
and  yf  ye  can  gette  any  syrupe  of  poppye,  geve  it  the  chylde  to  Iycke, 

15  The  nursing  mother  has  always  come  in  for  a  goodly  share  of  dietetic  instruc- 
tions, almost  all  without  rhyme  or  reason,  the  imaginings  of  old  women  or  unwise 
physicians  and  once  common  information;  it  takes  the  word  of  high  authority  to  do 
away  with  them.  Fortunately  at  present  the  better  informed  are  pretty  well  freed 
from  these  curious  deprivations. 


THOMAS  PHAER  165 

and  _than  make  a  playster  of  oyle*  of  saffron,  Iettuse,  and  the  iuyce  of 
poppye,  or  wette  cloutes  in  it,  and  Iaye  it  overtwharte  the  temples. 

Also  the  seades  and  the  heades  of  poppye,  called  chessbolles,  stamped 
wyth  rosewater,  and  myxte  wyth  womans  mylke,  and  the  white  of  an 
egge,  beaten  al  together  and  made  in  a  plaister,  causeth  the  chylde  to 
receive  his  natural  slepe. 

Also  an  ointmente  made  of  the  seede  of  popy  and  the  heades,  one 
ounce,  oile  of  Iettuse,  and  of  popye,  of  eche  .ii.  ounces,  make  an  oint- 
ment and  use  it. 

They  that  can  not  gette  these  oyles  maye  take  the  herbes,  or  iuyce 
of  Iettuse,  purcelane,  houseleke,  and  popye,  &  with  womans  mylke, 
make  a  playster,  and  Iaye  it  to  the  forehead. 

Oyle  of  violettes,  of  roses,  of  nenuphar,  are  good,  and  oyle  of  populeon, 
the  broth  of  mallowes  sodden,  and  the  iuyce  of  water  plantayne. 

OF  TERRIBLE  DREAMES  AND  FEARE  IN  THE  SLEPE 

Oftentymes  it  happeneth  that  the  child  is  afraid  in  the  slepe,  and 
sometimes  waketh  soodainly,  and  sterteth,  sometime  shriketh  and 
trembleth,  which  effect  commeth  of  the  arysyng  of  stynking  vapours, 
out  of  the  stomake  into  the  fantasye,  and  sences  of  the  brayne,  as  ye 
maye  perceyve  by  the  breath  of  the  chylde:  wherfore  it  is  good  to  geve 
him  a  Iitle  hony  to  swallow,  and  a  lytle  pouder  of  the  seedes  of  peonye, 
and  sometymes  treacle,  in  a  Iitle  quantity  with  milke,  and  to  take  hede 
that  the  chylde  sleepe  not  with  a  full  stomake,  but  to  beare  it  about 
wakying,  tyl  part  bee  dygested,  and  whan  that  it  is  Iaide,  not  to  rocke 
it  much,  for  overmuch  shaking  Ietteth  digestion,  and  maketh  the  chylde 
many  tymes  to  vomyte. 

THE  FALLYNGE  EVYLL  CALLED  IN  THE  GREKE  TONGE  EPILEPSIA 

Not  only  other  ages  but  also  lytle  chyldren,  are  oftentimes  afHycted, 
wyth  this  gryevouse  syckenes,  sometyme  by  nature  receyved  of  the 
parentes,  and  tha  it  is  impossible,  or  difficile  to  cure,  sometime  by  evil 
and  unholsome  diet,  whereby  there  is  engendred  many  colde  and  moist 
humors  in  the  brayne,  wherupo  this  infirmity  procedeth,  which  if  it  be 
in  one  that  is  younge  and  tender,  it  is  very  hard  to  be  removed,  but  in 
them  that  are  somewhat  strong,  as  of  seven  yeres  and  upwarde,  it  is 
more  easye. 

I  fynde  that  manye  thynges  have  a  natural  vertue  against  ye  falling 
evill,  not  of  any  qualitye,  elementall,  but  by  a  singuler  propertye,  or 
rather  an  influence  of  heaven,  whiche  almyghtye  god  hathe  geven  unto 
thynges  here  in  earth,  as  be  these  and  other. 

Saphires,  smaragdes,  redde  coral,  piony,  mystletow  of  the  oke  take 
in  the  moneth  of  March,  and  the  moone  decreasynge,  tyme,  savein,  dylle, 


166  PEDIATRICS  OF  THE  PAST 

and  the  stone  that  is  founde  in  the  bellye  of  a  yong  swallow  being  the 
first  brood  of  the  dame.  These  or  one  of  them,  hanged  about  the  necke  of 
the  child,  saveth  and  preserveth  it,  from  the  sayd  sickenes.  Now  wil  I 
describe  some  good  &  holsome  medicines  to  be  take  inward  for  thesame 
disease. 

If  the  chylde  be  not  very  young,  the  mawe  of  a  Ieueret,  dronke  with 
water  and  honye  cureth  thesame. 


A  MEDICINE  FOR  THE  FALLINGE  SYCKENESSE 

Take  the  roote  of  pionye,  and  make  it  into  pouder  and  geve  it  to  the 
childe  to  Iycke  in  a  Iitle  pappe  and  suger. 

They  that  are  of  age,  maye  eate  of  it  a  good  quantity  at  once  and 
likewise  of  the  blacke  sedes  of  thesame  piony. 

Item  the  purple  violettes  that  creapeth  on  the  ground  in  gardeines 
with  a  Ionge  stalke,  and  is  called  in  englishe  heartesease,  dronke  in  water, 
or  in  water  and  honye,  helpeth  this  dysease  in  a  younge  chylde. 

Moreover  the  muscle  of  the  oke  rased  and  geven  in  milke,  or  in  water 
and  honye  is  good. 

Also  ye  maye  styll  a  water,  of  the  floures  of  Iind,  it  is  a  tree  called  in 
latin  tilia,  thesame  whereof  they  make  ropes  and  halters  of  the  barke, 
take  ye  same  floures,  and  distyl  water,  and  Iette  the  pacient  drinke  of  it 
nowe  and  than  a  sponefull,  it  is  a  good  remedye. 

Item  the  rote  of  the  sea  thistle  called  Eringium  in  latin,  eaten  in 
broth,  or  dronken,  is  excedying  good. 

Some  write  that  cicory  is  a  singuler  remedye  for  thesame  disease.  It  is 
ment  by  wilde  cicorie,  growying  in  the  cornes. 

The  floures  of  rosemarye,  made  in  a  conserua  hath  thesame  effecte 
in  curyng  this  disease. 

I  could  declare  many  other  remedies,  commended  of  authours,  but 
at  thys  tyme  these  shalbe  sufficient. 

Nowe  I  wyll  entreat  somewhat  of  the  palsey. 


OF  THE  PALSEY   OR  SHAKYNG  OF  MEMBERS 

The  cure  of  the  palsey  in  a  child,  is  not  like  to  that,whiche  is  in  elder 
age,  for  the  synowes  of  a  childe  be  very  nesh,  and  teder,  &  therfore  thei- 
ought  to  have  a  much  weaker  medicyne,  evermore  regardynge  the  power 
of  the  syckenesse,  and  the  vertue  or  debylytye  of  the  grieved  pacient. 

For  some  times  the  chylde  can  not  lift  neyther  Iegges,  nor  armes, 
whiche  if  it  happen  duryng  the  suckynge,  than  must  the  nourse  use 
a  diet  enclinyng  to  hote  and  drye,  and  to  eat  spices,  as  galingale,  cina- 
mome,  ginger,  macis,  nutmygges,  and  suche  other,  wyth  rosted  and  fryed 


THOMAS  PHAER  167 

meates,  but  abstaine  from  mylke  and  al  maner  fyshe.  And  it  shall  be 
good  for  her,  to  eat  a  Iectuary  made  after  this  sorte. 

Take  mintis  cinamone,  cumine,  rose  leaves  dryed,  mastike,  fenu- 
greke,  valerian,  ameos  doronisi,  zedoarye,  cloves,  saunders,  and  lignum 
aloes,  of  every  one  a  dramme,  muske  half  one  drame,  make  an  electuary 
with  clarified  hony,  and  let  her  eat  of  it,  and  geve  the  chylde  as  muche 
as  halfe  a  nut  everye  daye  to  swallow. 

A  PLAISTER 

Take  an  ounce  of  waxe,  and  a  dramme  of  euphorbium,  at  the 
potecaries,  and  temper  it  with  oyle  olyve  on  the  fyer,  and  make  a  sere- 
cloth,  to  coumforte  the  backe  bone,  and  the  sinewes. 

A  GOODLY  LAUATORYE  FOR  THE  SAME  PURPOSE 

Take  lye  of  ashes,  and  seeth  therein  baye  buryes,  and  asmuch  piony 
sedes,  in  a  close  vessel  to  the  thyrde  parte  and  washe  the  childe,  often 
with  thesame. 

Item  of  bathe  of  saverye,  maiorym,  tyme,  sage,  nepte,  smallage, 
&  mintes,  or  some  of  them  is  verye  good  and  holesome. 

Also  to  rubbe  the  backe  of  the  chylde  and  the  Iimmes,  with  oyles  of 
roses,  and  spyke,  myxte  together  warme,  and  in  stede  of  it  ye  mai  take 
oyle  of  baies. 

OF  THE  CRAMPE  OR  SPASMUS 

This  diseases  is  often  sene  amog  chyldren  and  commeth  verye 
Iyghtely,  as  of  debilytye  of  the  nerves  and  cordes,  or  elles  of 
grosse  humors,  that  suffocate  thesame:  the  cure  of  ye  whiche  is  declared 
of  authours  to  bee  doone  by  friccions  and  oyntmentes  that  comfort  the 
sinowes  &  dissolve  the  matter,  as  oile  of  flouredeluyce,  with  a  Iitle  anyse, 
saffron  and  the  rootes  of  pionie. 

Item  oyle  of  camomil,  fenugreke,  and  mellilote,  or  the  herbes  sodde, 
betony,  wormewood,  verueyne,  and  tyme,  are  exceding  good  to  washe 
the  chylde  in. 

Item  the  plaister  of  euphorbium,  written  in  the  cure  of  palsey. 

OF  THE  STIFNES  OF  STARCKNES  OF  LIMMES 

Sometime  it  happeneth  that  the  Iymmes  are  starke,  &  can  not  well 
come  together  withoute  the  greater  peyne,  whiche  thynge  procedeth  mani 
times  of  cold,  as  whan  a  chylde  is  found  in  the  frost  or  in  the  streete, 
caste  awaye  by  a  wycked  mother,  or  by  some  other  chaunce,  although 
I  am  not  ignoraunt  that  it  maye  procede  of  manye  other  causes,  as  it  is 


168  PEDIATRICS  OF  THE  PAST 

sayde  of  Rasis,  and  of  Arnolde  de  villa  nova,  in  his  boke  of  the  cure  of 
infantes. 

And  here  is  to  bee  noted,  a  wonderfull  secret  of  nature,  manye  tymes 
approved,  written  of  Avicenne  in  hys  fyrste  Canon,  and  of  Celeus 
Antiquarum  electionu,  Iibro.  xiii.  capit.  xxxviii.  that  whan  a  meber  is 
utterly  benummed  and  taken  thorough  colde,  so  that  the  paciente  cannot 
feele  hys  Iymmes  nor  move  them  accordynge  to  nature,  by  reason  of 
the  vehement  congelacio  of  ye  bloud,  in  such  case  ye  chiefest  help  or 
remedy  is  to  not  set  them  to  the  fyer  to  receive  heat,  for  by  that  meanes, 
lightly  we  se  that  everi  one  swowneth  and  manye  dye  outeryghte,  but 
to  sette  the  feete,  Iegges,  and  armes,  in  a  payle  of  clere  colde  water, 
whiche  immediately  shal  dissolve  the  congelacio,  and  restore  the  bloud 
to  the  former  passage  and  fredome,  after  that  ye  mai  lay  the  pacient  in 
a  bed  to  sweate,  and  geve  him  hote  drinke  and  candels  or  a  coleis  of  a 
capon  hote,  with  a  Iitle  cinamome  &  saffro  to  cofort  the  hart.  An 
argument  of  this  cure  ye  may  se  thus. 

When  an  apple  or  a  pere  is  frosen  in  the  winter,  sette  it  to  the  fyre, 
and  it  is  destroyed:  but  yf  ye  putte  it  into  colde  water  it  shall  as  well 
endure,  as  it  did  afore,  whereby  it  doth  appere,  that  the  water  resolveth 
cold,  better  with  his  moysture,  than  the  fyer  can  do  by  reason  of  his 
heate:  for  the  water  relenteth  and  the  fyer  draweth  and  dryeth,  as  affyr- 
meth  Galene  in  hys  booke  of  elementes. 

Hitherto  have  I  declined  by  occasion,  but  I  trust  not  in  vayne  to 
the  reader,  now  to  my  purpose. 

When  a  yonge  childe  is  so  taken  with  a  colde,  I  esteme  it  best  for 
to  bath  the  bodye  in  Iuke  warme  water,  wherein  hath  bene  sodden 
Maiorim  and  time,  isope,  sage,  mintes,  and  suche  other  good  and  com- 
fortable herbes,  the  to  relieve  it  with  meates  of  good  nourishment, 
accordyng  to  the  age  and  necessity,  and  yf  neede  be,  when  ye  se  the 
limmes  yet  to  be  starke,  make  an  oyntmente  after  this  fourme. 


AN  OYNTMENT  FOR  STYFFE  AND  STOYNED  LIMMES 

Take  a  good  handefull  of  nettles,  and  stampe  them,  then  seth  them 
in  oyle  to  the  thirde  part  in  a  double  vessel,  kepe  that  oyntmet  in  a 
drye  place,  for  it  wil  last  a  great  while,  and  is  a  singuler  remedy  for  the 
styfnes  that  commeth  of  cold,  &  whoso  anoynteth  hys  handes  &  fete 
with  it  in  the  morning,  shal  not  be  grieved  with  colde  al  the  daye  after. 

The  sedes  of  nettles  gathered  in  harveste  and  kepte  for  thesame 
entente,  is  excedying  good  sodden  in  oyle,  or  fryed  with  swines  grece, 
which  thing  also  is  verye  good  to  heale  the  kybes  of  heeles,  called  in 
latin  Perniones.  The  urine  of  a  goate  with  the  donge  stamped  and  Iayed 
to  the  place,  resolveth  the  stifnes  of  limmes. 


THOMAS  PHAER  169 

When  the  cause  commeth  not  by  extreme  cold,  but  of  some  other 
affeccion  of  the  sinowes  and  cordes,  it  is  best  to  make  a  bath  or  a  fome- 
tacio  of  herbes  that  resolve  and  comfort  the  sinowes,  with  relaxacion 
of  the  grosse  humors,  &  to  open  the  pores,  as  by  exaple  thus. 

Take  Malowes,  holyhocke  and  dyl,  of  eche  a  handful  or  two,  seth  them 
in  the  water  of  netes  fete,  or  in  broth  of  flesh  without  salt,  with  a  handful 
of  branne  and  cumine,  in  the  which  ye  shall  bath  the  chyld,  as  warme  as 
he  may  suffer,  and  yf  ye  see  necessitie,  make  a  plaister  with  the  same 
herbes,  and  lay  it  to  the  griefe  with  a  Iitle  gosegrece,  or  duckes  grece, 
or  if  it  may  be  gotten,  oyle  of  camomil,  of  Iylyes,  and  if  dyll.  Cloutes 
wette  in  the  sayde  decoccion,  and  Iayd  about  the  members,  helpeth. 

OF  BLOUDE  SHOTTEN  EYES,  AND  OTHER  INFYRMITYES 

Sometyme  the  eyes  are  bloudeshotten,  and  other  whiles  encreasing 
a  filthi  and  white  humour,  covering  the  sight,  the  cause  is  often  of  to 
much  crying,  for  the  which  it  is  good  to  drop  in  the  eyes  a  Iitle  of  the 
iuyce  of  nighteshade,  other  wyse  called  morel,  and  to  annoint  the  fore- 
head with  the  same,  and  if  the  iye  swel,  to  wette  a  cloute  in  the  iuice, 
and  the  white  of  egges,  and  lay  it  to  the  grefe. 

If  the  humour  bee  clammyshe  and  tough,  and  cleveth  to  the  corners 
of  ye  eyes,  so  that  the  chylde  can  not  open  them  after  his  slepe,  it  shalbe 
removed  with  the  iuyce  of  housleke  dropped  on  the  eye  with  a  fether. 

When  the  eye  is  bloudeshotten  and  redde,  it  is  a  singuler  remedye 
to  putte  in  it,  the  bloude  of  a  yonge  pigion,  or  a  dove,  or  a  partriche, 
eyther  hoate  from  the  Bird,  or  els  dried  and  made  in  pouder,  as  subtyl 
as  maye  be  possible. 

A  PLAYSTER  FOR  SWELLYNG  AND  PAYNE  OF  THE  EYES 

Take  quinces  and  cromes  of  white  bread,  and  seeth  them  in  water 
tyl  thei  be  softe,  then  stampe  them,  and  with  a  Iitle  saffron  and  the  yolkes 
of  twoo  egges,  make  a  playster  to  the  childes  eyes  and  forehead.  Ye  may 
let  him  also  receive  the  fume  of  that  decoction.  It  is  also  good  in  the 
meigrim :  yf  ye  wyl  have  further,  Ioke  in  the  regiment  of  Iyfe,  in  the 
declaration  of  paynes  of  the  heade. 

OF  WATRYNG  EYES 

If  the  chyldes  eyes  water  overmuche,  withoute  crying,  by  reason  of 
a  distillacion  comming  from  the  head,  Manardus  teacheth  a  goodlye 
playster,  to  restrayne  the  reumes  and  is  made  thus. 

Hartes  home  brent  in  pouder,  and  washed  twise,  guaiacu,  otherwise 
called  lignum  sanctum,  corticumthuris,  antimonie,  of  eche  one  part, 


i7o  PEDIATRICS  OF  THE  PAST 

muske  the  iii.  part  of  one  parte,  make  a  fine  pouder  and  use  it  with  the 
iujce  or  water  of  fenel.  These  thinges  have  vertue  to  staunche  the  run- 
ning of  the  eyes.  The  shelles  of  snayles  brent,  the  ticke  that  is  found  in 
the  dugges  of  kyne,  philypendula,  frankensence  &  the  white  of  an  egge 
Iaied  upon  ye  forehead,  fleworte  or  the  water  wherin  it  is  steped,  tutie, 
ye  water  of  buddes  of  oke  stilled,  beane  floure  finely  sifted,  and  with  the 
gume  of  a  cheritree  steped  in  vineger,  &  Iayd  over  al  the  temples. 

OF  SCABBYNESSE  AND  YTCHE 

Sometyme  by  reason  of  excesse  of  heate,  or  sharpenesse  in  the  milke, 
throughe  the  nourses  eatyng  of  salt  &  eygre  meates,  it  happenethe  that  a 
chylde  is  sene  full  of  ytche  by  rubbing,  fretyng,  and  chafyng  of  it  selfe, 
encreasyng  a  scabbe  called  of  the  Grekes  Psora:  whyche  thynge  also 
chaunceth  unto  many  after  they  be  weaned,  procedinge  of  salte  and 
aduste  humoures,  the  cure  wherof  differethe  in  none  other,  but  according 
to  the  difference  of  age,  for  in  a  sucking  babe  ye  medicines  maye  not  be  so 
sharpe,  as  it  may  be  suffered  in  one  that  is  alredye  weaned.  Against 
suche  unkinde  ytche,  ye  maye  make  an  oyntment  thus. 

Take  water  of  betony,  ii.  good  handfulles,  daysye  leaves,  &  alehofe 
otherwyse  called  tunour  or  ground  yuye,  of  eche  one  handfull,  the  red 
docke  rotes,  two  or  thre,  stampe  them  al  togeyther,  and  grinde  them  wel, 
then  mingle  the  with  fresshe  grese,  and  againe  stampe  them.  Let  them  so 
stande.  viii.  daies  to  putrifye  tyll  it  be  hore,  then  frye  them  out  and 
strayne  them  and  kepe  it  for  the  same  entent. 

Thys  oyntment  hath  a  greate  effecte,  both  in  yong  and  olde,  and  that 
without  repercussion  or  dryving  backe  of  the  matter,  whyche  shoulde 
be  a  peryllouse  thynge  for  a  yong  chid. 

The  herbe  water  betonye  alone,  is  a  greate  medicyne  to  quenche 
al  unkinde  heates  without  dauger,  or  the  sething  of  it  in  cleare  well 
water,  to  annoynte  the  membres.  It  is  a  commen  herbe,  &  groweth  by 
ryvers  sydes  &  smal  renning  waters,  and  wette  places,  arysig  many  tymes 
the  heygth  of  a  ma  out  of  the  grounde,  where  he  reioyseth,  with  a  stalke 
foure  square,  and  many  brauches  on  every  syde,  and  also  it  beareth  a 
whytysh  blewe  flowre  very  smal,  &  in  harvest  it  hath  innumerable  seedes, 
blacke,  and  as  fyne  as  the  seed  of  tutsone  or  lesse,  the  Ieves  bygge  and 
log,  accordyng  to  the  ground,  ful  of  iuyce,  iagged  on  the  sides  like  a 
Sawe,  even  as  other  betonye,  to  whom  it  approcheth  in  figure,  &  obtein- 
eth  his  name  of  water  betony.  The  savoure  of  the  leafe  is  somwhat 
heavye,  moste  Iyke  to  ye  savoure  of  elders  or  walwort,  but  when  it 
is  brused  it  is  more  pleasaut,  whych  thyng  induceth  me  to  vary  fro  the 
myndes  of  them  that  thynke  this  herbe  to  be  Galiopsis  in  Dioscorides, 
wrytten  of  hym  that  it  shulde  stynke  when  it  is  stamped,  but  the  more  this 
herbe  is  stamped,  the  more  swete  and  herbelyke  it  savoureth:  therfore 


THOMAS  PHAER  171 

it  can  not  be  galeopsis;  and  besides  that,  it  is  never  founde  in  drye  and 
stony  groud  as  the  Galiopsis  is.  Neyther  is  thys  herbe  mencyoned  of  the 
newe  or  olde  authours :  as  farre  as  I  can  see,  but  of  only  Vigo,  ye  famous 
surgion  of  oure  tyme  in  Italye,  whych  wryteth  on  it,  that  this  herbe 
exceadeth  al  other  in  a  malo  mortuo  (so  calleth  he  a  kynde  of  Ieprye 
elephantyk,  or  an  universal  &  fylthy  scabbe  of  all  the  bodye:)  and  in 
Iyke  maner  he  sayeth  it  is  good  for  to  cure  a  canker  in  the  breastes.  Ye 
maye  reade  these  thinges  in  his  second  boke,  Capitul.  in.  and  his  fifte 
booke  of  the  Frenche  pockes,  in  the  thyrd  chapter:  where  he  doth 
describe  thys  aforesaid  herbe,  with  so  manyfeste  tokens,  that  no 
ma  wil  doubt  it  to  be  water  betony,  conferryng  the  boke  and  the  herbe 
duly  togither.  Moreover  he  nameth  in  Italye  a  brydge  where  it  growethe 
in  the  water  in  greate  aboundaunce,  and  is  called  of  ye  nacion  Alabeuer- 
atore,  which  in  dede  the  Italions  that  come  hyther  and  knowe  both  the 
place  and  the  herbe,  doe  affyrme  playnely,  it  is  our  water  betony.  And 
whereas  he  allegeth  Dioscorides  in  climeno,  which  by  cotemplacio  of 
both  hath  but  smal  affiniti  or  none  with  this  herbe,  it  was  for  nothinge 
els  but  lack  of  the  toges,  which  faute  is  not  to  be  so  highly  rebuked  in  a 
ma  of  his  study,  applying  himselfe  more  in  the  practyse  of  surgery,  &  to 
handye  operacio,  wherin  in  dede  he  was  nere  incomparable,  then  he  did  to 
search  ye  variauce  of  tonges,  &  rather  regarded  to  declare  ye  operacio  of 
thinges  with  truthe,  then  to  dispute  upon  the  propertyes  or  names  with 
eloquence. 

Thus  have  I  declyned  agayne  from  my  matter,  partly  to  shewe  ye 
descripcion  of  thys  holesome  herbe,  partelye  to  satisfie  the  mindes  of 
ye  surgions  in  Vigo,  whiche  have  hitherto  redde  the  sayd  places  in  vayn, 
and  furthermore  bicause  ther  is  yet  none  that  declareth  manyfestly 
the  same  herbe. 


AN  OTHER  REMEDYE  FOR  SCABBES  AND  YTCHE 

Take  the  rootes  of  dockes,  and  frye  the  in  fresh  grese,  then  put  to  it 
a  quatitie  of  brimstone  in  pouder,  and  use  to  rubbe  the  places  twise  or 
thrise  a  day.  Brimstone  poudred  &  suuped  in  a  rere  egge  healeth  the 
scabbes,  which  thing  is  also  very  good  to  destroye  wormes. 


A  GOODLY  SWETE  SOPE  FOR  SCABBES  AND  YTCHE 

Take  whyte  sope  halfe  a  pounde,  and  stepe  it  in  suffyciente  rose  water, 
til  it  be  wel  soked,  then  take  two  drammes  of  mercurye  sublymed, 
dissolve  it  in  a  Iytle  rosewater,  labour  the  sope  and  ye  rosewater  wel 
together,  &  afterward  put  it  in  a  Iitle  muske  or  cyuette,  and  kepe  it. 
This  sope  is  exceding  good  to  cure  a  great  scabbe  or  ytche,  and  that  with- 


i72  PEDIATRICS  OF  THE  PAST 

out  perill,  but  in  a  chylde  it  shall  suffyce  to  make  it  weaker  of  the 
mercurye.18 

AN  OTHER  APPROUED  MEDICINE  FOR  SCABBYNESSE  AND  YTCHE 

Take  fumyterie,  docke  rootes,  scabiouse,  &  the  roote  of  walwort, 
stampe  them  al,  &  set  the  in  fresh  grese  to  putrifye,  then  frye  them  and 
strayne  the,  in  which  Iycour  ye  shal  put  turpetine  a  Iytle  quantitie, 
brymstone,  and  frakensence  very  fynely  poudred  and  sifted  a  porcio,  and 
with  sufficient  waxe  make  an  ointment  on  a  softe  fyer:  this  is  a  singuler 
remedy  for  the  same  purpose.  But  I  this  cure  ye  ought  to  gyve  the  chylde 
no  egges,  nor  any  eygre  or  sharpe  meate,  and  the  nurce  also  muste 
avoyde  the  same,  and  not  to  wrappe  it  in  to  hoote,  and  yf  neade  be,  to 
make  a  bathe  of  fumitorye,  centaurye,  fetherfewe,  tansie,  wormwood, 
and  sauge  alone,  yf  ye  se  the  cause  of  the  ytche  or  the  scabbe  to  be  wormes 
in  ye  skinne,  for  a  bytter  decoccion  shal  destroy  the,  and  dry  up  the 
moistures  of  the  sores. 

OF  DISEASES  IN  THE  EARES 

Many  diseases  happen  in  the  eares,  as  payne,  apostemes,  swellynges 
tynklynge  and  soud  in  the  heed,  stoppinge  of  the  organes  of  hearynge: 
Water,  wormes,  &  other  infortunes  gotten  into  the  eares,  wherof  some  of 
them  are  daungerous  and  harde  to  be  cured,  some  other  expelled  of 
nature  without  medicyne. 

REMEDYE  FOR  PAYNE  IN  THE  EARES 

For  payne  in  the  eares  wythout  a  manifest  cause,  as  often  chaunceth, 
it  is  a  singuler  remedye  to  take  the  chest  wormes,  that  are  found  under 
barkes  of  trees,  or  in  other  stumpes  in  the  groud  &  wil  turne  rounde 
like  a  pease,  take  of  them  a  good  quantytye,  and  seeth  them  in  oyle,  in 
the  rynde  of  a  pomegranarde  on  the  hote  ymbres,  ye  it  brenne  not,  and 
after  that  straine  it  and  put  into  the  eares  a  droppe  or  two  Iuke  warme, 
and  then  Iette  him  lye  upon  the  other  eare,  and  reste.  Ye  maye  gyve 
thys  to  al  ages,  but  in  a  child  ye  must  put  a  very  Iytle  quantitie. 

AN  OTHER 

The  hame  or  skynne  of  an  adder  or  a  snake,  that  she  casteth,  boiled 
in  oile,  &  dropped  into  the  eares,  easeth  ye  paine,  &  it  is  also  good  for  an 
eare  that  mattereth  mingled  with  a  Iitel  hony,  and  put  in  Iuke  warme. 
It  is  also  good  to  droppe  into  the  eares  the  iuyce  of  organye  and  mylke. 

13  The  use  of  both  the  above  ointments  is  sound  therapy.  It  would  be  interesting 
to  know  just  what  the  ointment  was  like,  but  one  gathers  the  impression  that  many 
of  the  medicaments  of  the  period  were  pleasant  to  smell  and  to  look  upon,  just  as 
many  were  the  reverse. 


THOMAS  PHAER  173 

FOR  SWELLYNG  UNDER  THE  EARES 

Paynters  oyle,  which  is  oyle  of  Iyneseed,  is  excedyng  good  for  ye 
swellyng  of  the  eares,  and  for  paine  in  the  eares  of  all  causes. 

Item  a  plaister  made  of  Iineseede  and  dille,  with  a  Iitle  duckes 
grese  &  hony.  Yf  ye  se  the  aposteme  breke,  &  renne,  ye  may  dense  it 
with  the  iuce  of  smallach,  the  white  of  an  egge,  barly  flour,  and  hony, 
which  is  a  common  plaister  to  mundifye  a  sore. 

When  the  eares  have  received  water  or  any  other  Iicour,  it  is  good 
to  take  and  stampe  an  onion  and  wryng  out  ye  iuce  with  a  Iitle  gosegrese, 
&  droppe  it  hote  into  the  eare  as  it  may  be  suflfred,  and  Iaye  hym  downe 
on  the  contrary e  syde  an  houre,  after  that  cause  hym  to  nese  yf  his  age 
will  suffre,  with  a  Iitle  pellitorie  of  spayne,  or  nesinge  pouder,  and  then 
enclyne  his  eare  downewarde,  that  the  water  maye  issue. 

FOR  WORMES  IN  THE  EARES 

Take  myrre,  aloes,  and  the  seede  of  colocinthis,  called  coloquintida 
of  the  apothecaries,  a  quantity  of  eche,  seeth  the  in  oile  of  roses,  &  put  a 
Iitle  1  ye  eare.  Myrre  hath  a  great  vertue  to  remove  the  stenche  that  is 
caused  in  the  eares  by  any  putrefaction,  and  the  better  with  oyle  of  bitter 
almons,  or  ye  may  take  ye  iuce  of  wormwood  with  honye  and  salte  peter. 

FOR  WYNDE  IN  THE  EARES  AND  TINKLYNG 

Take  myrre,  spykenarde,  cumyne,  dylle,  and  oyle  of  camomyl,  and 
put  a  droppe  in  ye  eares.  They  that  have  not  al  these,  maye  take  some  of 
them,  and  applye  it  accordyng  to  discretion. 

To  amende  deafnesse  ye  shal  make  an  ointment  of  an  hares  galle, 
and  the  grese  or  droppyng  of  an  ele,  which  is  a  souerayne  thyng  to 
recover  hearynge. 

OF  NESYNG  OUT  OF  MEASURE 

When  a  chylde  neseth  out  of  measure,  ye  is  to  say,  with  a  Ionge 
continuaunce  and  therby  the  braine  and  vertues  animal  be  febled,  it  is 
good  to  stoppe  it,  to  avoyde  a  further  inconvenience. 

Wherfore  ye  shal  annoynt  the  heade  wyth  the  iuyce  of  purcelane, 
sorel,  &  nyghtshade,  or  some  of  them,  and  make  a  playster  of  the  whyte 
of  an  egge,  and  the  iuyce,  with  a  Iitle  oyle  or  roses,  &  emplayster  the  for- 
head  and  temples,  with  the  mylke  of  a  woman,  oyle  of  roses,  and  vynegre 
a  Iytle. 

If  it  come  of  colde  reume,  ye  shall  make  a  playster  of  mastyke, 
frankensens,  myrre,  wine,  and  apolye  it  to  ye  former  parte  of  the  head: 
A  fome  of  the  same  receyved  in  flaxe,  and  Iayed  upon  the  chyldes  head, 
is  holsome. 


i74  PEDIATRICS  OF  THE  PAST 


BREEDYNG  OF  TEETH 

About  ye  seveth  moneth,  somtime  more,  somtyme  Iesse  after  ye 
byrth,  it  is  natural  for  a  chyld  for  to  breede  teeth,  in  which  time  many 
one  is  sore  vexed  with  sodry  diseases  &  peines,  as  swelling  of  ye  gummes 
&  iawes,  unquiete  cryeng,  fevers,  crampes,  palsies,  fluxes,  Reumes,  and 
other  infirmities,  specially,  wha  it  is  log  or  ye  teeth  come  forth,  for  the 
soner  they  appere,  the  better,  and  the  more  ease  it  is  to  ye  childe.  There 
be  divers  thinges  ye  are  good  to  procure  an  easy  breeding  of  teeth,  among 
whom  the  chiefest  is  to  annoint  the  gummes,  with  the  braynes  of  an  hare, 
myxte  with  asmuch  capons  grece  and  hony,  or  any  of  these  thynges 
alone,  is  exceadynge  good  to  supple  the  gummes  and  the  synewes. 

Also  it  is  good  to  wasshe  the  chylde  two  or  three  tymes,  in  a  weeke, 
with  warme  water,  of  the  decoccion  of  camomyll,  hollyhocke  and  dille. 

Freshe  butter,  with  a  Iitle  barly  flour  or  honye,  with  the  fine  pouder 
of  frakinsence  &  Iiquirice,  are  commeded  of  good  authoures  for  the  same 
entente.  And  whan  the  peyne  is  greatte,  and  intollerable,  with  aposteme 
or  inflammation  of  the  goummes,  it  is  good  to  make  an  ointmet  of  oile  of 
roses,  with  iuyce  of  morelle,  otherwise  called  nyghtshade,  and  in  Iacke 
of  it,  annoint  the  iawes  within,  with  a  Iitle  fresshe  butter  and  honye. 

For  Iacke  of  the  hares  brayne,  ye  may  take  the  conyes,  for  they  be 
also  of  the  kyndes  of  hares,  and  called  of  Plinye  Dasypodes,  whose  mawes 
are  of  the  same  effecte  in  medicine,  or  rather  more,  then  is  written  of 
authoures,  of  the  mawes  of  hares. 

If  ye  se  the  gummes  of  the  chylde  to  aposteme,  or  swelle  with  softe 
flesshe,  full  of  matter  and  paynefull,  the  beste  shal  be  to  annoint  the  sore 
place  with  the  brayne  of  an  hare,  &  capons  grece,  equally  myxt  togither, 
and  after  that  ye  have  used  thys,  ones  or  twise,  annoynte  the  gummes, 
and  apostumacions  with  honye. 

Thyrdlye  yf  this  helpe  not,  take  turpentyne  myxte  with  a  little  hony 
in  equal  porcion.  And  make  a  bath  for  the  head  of  the  chylde,  in  this 
fourme. 

Take  the  floures  of  camomylle  and  dyl,  of  eche  an  handful,  seeth 
them  in  a  quarte  of  pure  rennyng  water,  until  they  be  tender,  and  wasshe 
the  head  afore  any  meate,  everye  mornyng,  for  it  pourgeth  the  super- 
fluytye  of  the  braynes,  through  the  seames  of  the  skull,  and  wythdraweth 
humours  from  the  sore  place,  fynally  coforteth  ye  braine  and  al  the 
vertues  animal  of  the  child. 

To  cause  an  easie  breedyng  of  teethe,  many  thiges  are  rehersed  of 
auctours,  besydes  the  premisses,  as  the  fyrst  cast  tooth  of  a  colte  set  in 
sylver  &  borne,  or  redde  coralle  in  Iyke  maner,  hanged  about  the  necke, 
wher  upon  the  chylde  shuld  oftentimes  labour  his  gummes,  and  many 
other  Iyke,  whyche  I  leave  out  at  this  time,  to  avoide  tediousnes,  onely 


THOMAS  PHAER  175 

content  to  declare  this  of  coral,  that  by  consent  of  al  authours,  it  resisteth 
the  force  of  Iyghtenyng,  helpeth  the  chyldren  of  the  fallynge  evyll,  and 
is  verye  good  to  be  made  in  pouder,  &  dronken  against  al  maner  of  bleed- 
ing of  the  nose  or  fundament. 

OF  A  CANKER  IN  THE  MOUTHE 

Many  tymes  by  reson  of  corrupcion  of  the  milke,  venimous  vapoures 
arising  from  the  stomake,  &  of  many  other  infortunes  there  chaunceth 
to  brede  a  caker  in  ye  mouthes  of  childre,  whose  signes  are  manifest 
ynough,  ye  is  to  saye  by  stinking  of  the  mouthe,  peyne  in  the  place, 
contynual  rennyng  of  spittle,  swellynge  of  the  cheke,  and  when  the 
mouth  is  opened  against  the  sonne,  ye  maye  se  clereye  where  the  canker 
Iieth.  It  is  so  named  of  the  latter  sort  of  phisicions,  by  reason  of  crepynge 
and  eatynge  forwarde  and  backewarde,  and  spreadeth  it  selfe  abrode, 
Iyke  the  feete  of  a  creues,  called  in  Iatine  cancer,  notwithstanding  I 
knowe  that  the  Greekes,  and  auncient  Iatynes,  gyve  other  names  unto 
thys  dysease,  as  in  callynge  it  an  ulcer,  other  whyles  aphthe,  nome, 
carcinomata,  and  Iyke,  which  are  al  in  englyshe,  knowen  by  the  name  of 
canker  in  the  mouthe,  and  although  there  be  many  kindes  according  to 
the  matter  wherof  they  be  engendred,  &  therfore  require  a  diversitie 
of  curing,  yet  for  the  moste  parte,  whan  they  be  in  childerne,  the  cure  of 
them  al  differeth  very  Iitle  or  nothing,  for  ye  chiefe  entent  shal  be 
to  remove  the  malignitye  of  the  sore,  and  to  drye  up  the  noisome  matter 
and  humours,  tha  to  mundify  and  heale,  as  in  other  kindes  of  ulcers, 
sores,  and  woundes. 

REMEDIES  FOR  THE  CANKER  IN   THE  MOUTH  OF  CHILDREN 

Take  drye  redde  roses,  &  violettes,  of  eche  a  Iyke  quantity,  make 
them  in  pouder,  and  myxt  them  with  a  Iytle  honye,  thys  medicine  is 
verye  good  in  a  tender  suckynge  childe,  and  many  times  healeth  alone, 
without  any  other  thing  at  al.  But  yf  ye  se  there  be  great  heat  &  burning 
in  the  sore,  with  exceding  paine,  ye  shal  make  a  iuice  of  purcelane,  Iet- 
tuse  &  nightshade,  &  wash  the  sore  wyth  a  fyne  pyece  of  sylk,  or  driue 
it  in  with  a  spoute,  called  of  the  surgions  a  sprynge. 

This  by  the  grace  of  God,  shall  abate  the  brennyng,  aswage  the  peyne, 
and  kyl  the  venime  of  the  ulcer. 

But  yf  ye  see  the  canker  yet  encrease  with  great  corrupcio  &  matter, 
ye  shal  make  an  oyntmente  after  this  maner. 

Take  mirre,  galles  wherewith  they  make  ynke,  or  in  defaute  of  them, 
oken  apples  dryed,  frankinsence,  of  eche  a  Iyke  much,  of  the  blacke 
buries  growynge  on  the  bramble,  taken  from  the  bushe  while  they  be 
grene,  the  .iii.  part  of  al  the  rest,  make  them  al  in  pouder,  and  mixt  them 
with  asmuch  hony  and  saffron,  as  is  sufficient,  and  use  it. 


176  PEDIATRICS  OF  THE  PAST 

A  STRONGER  MEDICINE  FOR  THE  CANKER  IN  THE  MOUTH  OF  CHILDREN 

Take  the  roote  of  celidonye  dryed,  the  rinde  of  a  pomegranate,  redde 
corall  in  pouder,  &  the  pouder  of  a  hartes  home,  of  eche  a  Iyke,  roche 
alume  a  Iitle.  Fyrste  washe  the  place  wyth  wine,  or  warme  water,  and 
hony,  and  afterwarde  putte  on  the  foresayd  pouder,  very  fyne  and 
subtyle. 

AN  OTHER  SINGULER  MEDICINE  FOR  THE  CANKER  IN  THE  MOUTH  OF 

AL  AGES 

1$.  ysope,  sage,  rue,  of  eche  one  good  handeful,  seeth  them  in  wyne 
and  water,  to  the  thirde  part,  then  straine  the  out,  and  putte  in  it  a  Iitle 
white  coperose,  accordyng  to  necessitye:  that  is  to  saye,  whan  the  sore  is 
great,  put  in  the  more,  when  it  is  small,  ye  maye  take  ye  Iesse,  than  adde 
to  it  a  quantitie  of  hony  claryfied,  and  a  sponeful  or  twoo  of  good  aqua 
vite;  washe  the  place  wyth  it,  for  it  is  a  singuler  remedye,  to  remove  ye 
malice  in  a  short  while,  which  done  ye  shal  make  a  water  incarnative  and 
healyng  thus.  R.  rybwoort,  betonye  and  dayses,  of  eche  a  handefull, 
seeth  them  in  wyne  and  water,  and  washe  hys  mouth,  two  or  thre  times  a 
day  with  the  same  iuce.  Moreover  some  write  ye  christal  made  in  fyne 
pouder,  hath  a  singuler  vertue  to  destroie  the  canker,  and  in  Iyke  maner 
the  pouder  of  an  harteshorne  bret  with  asmuche  of  the  rinde  of  a  pome- 
granade,  and  the  iuyce  of  nyghtshade,  is  very  good  and  holsome. 

OF  QUINSYE  AND  SWELLYNG  OF  THE  THROTE 

The  quinsy  is  a  daugerous  sicknes  both  in  young  &  olde,  called  in 
latin  angina,  it  is  an  inflammacion  of  the  necke  with  swellyng  and  greate 
peyne,  sometyme  it  Iyeth  in  the  verye  throte,  upon  the  wesaunt  pype, 
and  than  it  is  exceding  perillous  for  it  stoppeth  the  breath,  &  stranguleth 
the  pacient  anone. 

Other  whyles  it  breaketh  out  like  a  bonche  on  the  one  syde 
of  the  necke,  and  than  also  with  verye  great  dyffycultye  of  breathynge, 
but  it  choketh  not  so  sone  as  the  fyrst  doeth,  and  it  is  more  obediente  to 
receive  curacion. 

The  signes  are  apparaunt  to  syghte,  &  besides  that  the  chylde  can  not 
crye,  neyther  swallow  downe  his  meat  and  drynke  without  payne. 

REMEDYE 

It  is  good  to  annoynt  the  griefe  with  oyle  of  dyll,  or  oyle  of  camomyll, 
and  Iylies,  and  to  Iaye  upon  the  head,  hote  cloutes  dipte  in  the  waters  of 
rosemary,  lavender,  and  savery. 

The  chiefest  remedy  commended  of  authours  in  this  outragious  sicke- 
nes,  is  the  pouder  of  a  swallow  brent  wyth  fethers  and  all,  and  myxte  with 


THOMAS  PHAER  177 

hony,  whereof  the  paciente  muste  swallowe  downe  a  Iitle,  and  the  reste 
annoynted  upon  the  payne.  They  prayse  also  the  pouder  of  the  chyldes 
dunge  to  the  chyld,  and  of  a  man  to  a  man,  brent  in  a  pot,  and  annointed 
with  a  Iitle  hony.  Some  make  a  compouned  oyntmente  of  both,  the  receite 
is  thus.  r.  of  the  swallow  brent,  one  porcion,  of  the  second  pouder  another, 
make  it  I  a  thicke  fourme  with  hony,  and  it  wyll  endure  Ionge  for  the 
same  entent. 

Item  an  other  experiment  for  the  quinsy  and  swellynge  under 
the  eares. 

Take  the  musherim  that  groweth  upon  an  elder  tree,  called  in  englysh, 
Jewes  eares  (for  it  is  in  dede  croncled  and  flat,  muche  Iyke  an  eare)  heat 
it  agaynst  the  fyer,  and  put  it  hote  in  anye  drinke,  the  same  drinke  is  good 
&  holesome  for  the  quinsye. 

Some  hold  opinion  that  whoso  useth  to  drinke  with  it,  shall  never  bee 
troubled  with  the  disease,  and  therefore  carye  it  about  with  them  in 
iorneys. 

OF  THE  COUGH 

The  cough  in  children  for  ye  most  part,  procedeth  either  of  a  cold, 
or  by  reason  of  reumes,  descending  from  the  head  into  ye  pipes  of  the 
Ionges  or  the  breaste,  and  that  is  most  commonly  by  overmuche  aboun- 
daunce  of  milke,  corruptyng  the  stomake  and  brayne:  therefore  in  that 
case,  it  is  good  to  fede  the  chylde  wyth  a  more  slender  dyete,  and  to 
annoynte  the  head  over,  with  hony,  and  now  and  than  to  presse  his 
toungue  wyth  youre  fynger,  holdyng  downe  hys  heade  that  the  reumes 
may  issue,  for  by  ye  meanes  the  cause  of  the  cough  shall  runne  oute  of 
his  mouthe,  and  avoyde  the  chylde  of  many  noughty  and  slimy  humours: 
whiche  done,  many  tymes  the  paciente  amendeth,  wythout  any  further 
helpe  of  medicine. 

FOR  THE  COUGH  IN  A  CHYLDE 

Take  gumme  arabike,  gumme  dragagant,  quince  sedes,  Iiquirice 
and  penidies,  at  the  pothecaries,  break  them  al  together,  and  geve  the 
childe  to  suppe  a  Iitle  at  once,  with  a  draughte  of  milke  newli  warme,  as 
it  commeth  from  the  cowe. 

Also  stampe  blaunched  almons,  and  wringe  them  out  with  the 
iuyce  of  fenell,  or  water  of  fenell,  and  geve  it  to  the  chylde  to  fede  with  a 
Iitle  suger. 

AGAINST  THE  GREAT  COUGH,  AND  HEATE  IN  THE  BODYE 

The  heades  of  whyte  poppye,  and  gumme  dragagant,  of  eche  a  like 
much,  long  cucumer  seedes,  as  muche  as  al,  seth  them  in  whaye,  wyth 


178  PEDIATRICS  OF  THE  PAST 

raysons  and  suger,  and  Iette  the  chylde  drynke  of  it  twyse  or  thryse  a 
daye  Iuke  warme,  or  colde. 

OF  STRAYTENESSE  OF  WYNDE 

Against  the  straitnesse  of  breathyng,  whiche  is  no  quinsie,  the 
consente  of  authours  do  attribute  a  great  effecte,  to  Iynesede  made  in 
pouder,  &  tempered  with  hony,  for  the  chylde  to  swallowe  downe  a 
Iytle  at  once.  I  finde  also  ye  the  mylke  of  a  mare  newly  received  of  ye 
chyld  with  suger,  is  a  singuler  remedy  for  yesame  purpose.  Which  thing 
moreover,  is  excedynge  holesome  to  make  the  belly  Iaxe  without  trouble. 

OF  WEAKENES  OF  THE  STOMAKE,  AND  VOMITYNG 

Mani  times  the  stomacke  of  the  child  is  so  feble  that  it  canot  retain 
eyther  meat  or  drinke,  in  which  case,  and  for  al  debilitye  therof,  it  is 
verye  good,  to  washe  the  stomake,  with  warme  water  of  roses,  wherein  a 
Iitle  muske  hathe  beene  dissolved,  for  that  by  the  odour  and  natural 
heate  geveth  a  comfort  to  all  the  spirituall  members. 

And  then  it  is  good  to  rost  a  quince  tender,  &  with  a  Iitle  pouder  of 
cloves  and  suger  to  give  it  to  the  child:  to  eat  coserua  qulces,  with  a  Iitle 
cinamone  and  cloves,  is  synguler  good  for  thesame  entent.  Also  ye  may 
make  a  iuice  of  quinces  and  geve  it  to  the  chylde  to  drinke  with  a  little 
suger. 

AN  OYNTMENTE  FOR  THE  STOMAKE 

Take  gallia  muscata  at  the  pothecaries  .xx.  graine  weight,  myrrhe  a 
verye  Iitle,  make  it  up  in  oyntment  fourme,  with  oyle  of  mastike,  and 
water  of  roses  sufficient,  this  is  a  very  good  ointment  for  the  stomake. 

AN  OTHER  SINGULER  RECEIT 

Take  mastike,  frankinsence,  and  drye  redde  roses,  as  muche  as  is 
sufficient,  make  them  in  pouder,  and  temper  the  up,  with  the  iuyce  of 
mintes,  and  a  sponful  of  vineger,  and  use  it. 

AN  OTHER 

Take  wheat  floure  and  parche  it  on  a  panne,  tyll  it  begynne  to  brenne 
and  waxe  redde,  than  stampe  it  with  vineger,  and  adde  to  it,  the  yolkes 
of  twoo  egges  harde  rosted,  mastike,  gumme,  &  frankinsence  sufficient, 
make  a  plaister  and  Iaye  it  to  the  stomake. 

TO  RECOVER  AN  APPETITE  LOST 

Take  a  good  handfull  of  ranke  and  Iustye  rewe  and  seth  it  in  a  pint 
of  vyneger  to  the  thyrde  parte  or  Iesse,  and  make  it  very  stronge,  wherof 


THOMAS  PHAER  179 

yf  it  be  a  childe,  ye  may  take  a  tooste  of  brown  bread,  and  stampe  it  with 
thesame  vyneger  and  Iaye  it  plaisterwyse  to  the  stomake  and  for  a 
stronger  age  besides  the  plaister,  let  hym  suppe  morning  and  evenyng 
of  thesame  vineger.  This  is  also  good  to  recover  a  stomak  lost,  by  com- 
ming  to  a  fyer  after  a  long  iourneye,  and  hath  also  a  singuler  vertue  to 
restore  a  man  that  swowneth. 

AN    EXPERIMENT    OFTEN    APPROVED    OF    RASIS    [RHAZES]     FOR    THE 

VOMITE  OF  CHYLDREN 

Rasis  a  solemne  practicioner  amonge  phisicions,  afFyrmeth  that  he 
healed  a  great  multitude  of  this  disease,  onelye  with  the  practise  follow- 
inge,  whiche  he  taketh  to  bee  of  great  effect  in  all  Iyke  cases. 

Fyrst  he  maketh  as  it  were  an  electuarye  of  pothecarye  stuffe,  that  is 
to  saye,  lignum  aloes,  mastike  of  everye  one  half  a  dramme,  galles  half  a 
scruple,  make  a  Iectuary  with  syrup  of  roses,  and  gallia  muscata  and 
suger. 

Of  this  he  gave  the  children  to  eat  a  very  Iitle  at  once  &  often.  After- 
warde  he  made  a  plaister  thus.  r.  mastike,  aloes,  sloes,  galles,  franken- 
sence,  and  brent  bread,  of  ech  a  like  porcion,  make  a  plaister  with  oile 
and  sirupe  of  roses  to  be  laid  to  the  childes  stomake  hote. 

AN  OTHER  OYNTMENT  FOR  THE  STOMAKE,  DESCRIBED    OF   WILHEL. 

PLACENTINO 

Take  oyle  of  mastike  or  of  wormewood  .ii.  ounces,  waxe  .Hi.  ounces, 
cloves,  macis,  and  cinamome,  of  eche  thre  drammes,  make  an  oyntment, 
adding  in  the  ende  a  Iitle  vineger. 

The  yolke  of  an  egge  hard  rosted,  mastyke,  frankinsence  and  gumme, 
made  in  a  playster  with  oyle  of  quinces,  is  excedyng  good  for  the  same 
purpose. 

OF  YEAXING  OR  HICKET 

It  chaunceth  oftetymes  that  a  chyld  yeaxethj  out  of  measure. 
Wherfore  it  is  expedient  to  make  the  stomake  eigre  afore  it  be  fed,  & 
not  to  replenish  it  wyth  to  much  at  once,  for  this  dysease  comonly  pro- 
cedeth  of  fulnes,  for  yf  it  come  of  emptines,  or  of  sharp  humors  in  the 
mouth  of  the  stomake,  which  is  seldome  sene:  the  cure  is  then  very  difficill 
and  daungerous. 

REMEDYE 

When  it  commeth  of  fulnesse  that  a  chylde  yeaxeth  incessantlye 
withoute  measure  and  that  by  a  long  custome,  it  is  good  to  make  him 


i8o 


PEDIATRICS  OF  THE  PAST 


vomit  with  a  fether  or  by  some  other  Iighte  meanes,  ye  the  matter  which 
causeth  the  yeaxynge,  mai  issue  and  uncomber  the  stomake,  ye  done, 
brynge  it  a  slepe,  and  use  to  annointe  the  stomake  with  oyles  of  castor, 
spike,  camomyll,  and  dyll,  or  twoo  or  .iii.  of  them,  ioined  together,  warme. 

OF  COLIKE  AND  RUMBLYNG  IN  THE  GUTTES 

Peine  in  the  belly  is  a  common  disease  of  children,  it  commeth  either 
of  wormes,  or  of  taking  cold,  or  of  evyl  mylke,  ye  signes  thereof  are  to 
well  knowen,  for  the  chylde  cannot  rest,  but  cryeth  and  fretteth  it  selfe, 
and  manye  tymes  cannot  make  theyr  uryne,  by  reason  of  winde,  that 
oppresseth  the  necke  of  the  bladder,  and  is  knowen  also,  by  the  member 
in  manne  chylde,  which  in  thys  case,  is  alwaye  stifFe,  &  pricking,  more- 
over the  noyse  and  rumblinge  in  the  guttes,  hither  and  thyther,  declareth 
ye  chylde  to  be  greved,  with  winde  in  the  belly,  and  colike. 

CURE 

The  nourse  muste  avoyde  all  maner  of  meates,  that  engeder  wind, 
as  beanes,  peason,  butter,  harde  egges,  and  suche.  Than  washe  the 
childes  bellye  with  hote  water  wherein  hath  bene  sodden  comine,  dyll 
and  fenel,  after  that  make  a  playster  of  oyle  and  waxe,  and  clappe  it 
hote  upon  a  cloth  unto  the  belly. 

AN  OTHER  GOOD  PLAYSTER  FOR  THESAME  ENTENT 

Take  good  stale  ale  and  freshe  butter,  seeth  them  with  an  handfull  of 
comine  poudred,  and  after  put  it  all  together  into  a  swines  bladder,  & 
bynde  the  mouth  faste,  that  the  Iicoure  yssue  not  out,  then  wind  it  in 
a  cloth,  &  turne  it  up  and  doune  upon  the  belly  as  hote  as  the  pacient 
may  suffer,  this  is  good  for  the  colike  after  a  sodayne  colde,  in  all  ages, 
but  in  chyldren  ye  muste  beeware  ye  applye  it  not  to  hote. 

OF  FLUXE  OF  THE  BELLYE 

Manytymes  it  happeneth,  eyther  by  takynge  colde,  or  by  reason  of 
great  pain  in  breading  of  teeth,  or  els  through  salt  and  eiger  fleume  or 
cholere  engendred  in  the  bodye,  that  the  chylde  falleth  in  a  soodayne 
Iaxe,  whiche  yf  it  Ionge  continue  and  bee  not  holpen,  it  may  bring  the 
pacient  to  extreme  Ieanes,  and  consumpcio:  wherfore  it  shall  be  good  to 
seke  some  holsome  remedi,  &  to  stop  the  runnynge  of  the  fluxe  thus. 


REMEDY  FOR  THE  FLUXE  IN  A  CHYLDE 

First  make  a  bath  of  herbes  that  doe  restrayne,  as  of  plantaine,  saint 
Johns  weede  called  ipericon,  knotgrasse,  bursa  pastoris  and  other  suche, 


THOMAS  PHAER  181 

or  some  of  them,  and  use  to  bath  him  in  it  as  hote  as  he  mai  wel  suffer, 
then  wrap  him  in  with  clothes,  and  Iaye  hym  downe  to  slepe. 

And  yf  ye  se  by  this  twise  or  thryse  using,  that  the  belly  bee  not 
stopped:  Ye  maye  take  an  egges  yolke  harde  rosted,  and  grinde  it  with  a 
Iitle  saffron,  myrrhe  and  wyne,  make  a  plaister,  and  apply  to  the  navyl 
hote.  Yf  this  succede  not,  then  it  shalbe  necessary  for  to  make  a  pouder 
to  geve  him  I  his  meat  with  a  Iitle  suger,  and  in  a  smal  quantitye  thus. 

Take  the  pouder  of  hartes  home  bret,  the  pouder  of  goates  clawes, 
or  of  swines  clawes  brent,  the  pouder  of  ye  sede  of  roses  which 
remain  in  the  bery  when  the  rose  is  fallen,  of  every  one  a  porcion,  make 
them  verye  fyne,  &  with  good  redde  wyne  or  almon  mylke,  and  wheat- 
floure,  make  it  as  it  wer  a  paste,  and  drye  it  in  Iitle  balles  tyll  ye  se 
necessity e,  it  is  a  singuler  remedy e  in  all  sutch  cases. 

Item  the  mylke  wherein  hath  bene  sodden  white  paper,  and  after- 
warde  quenched  many  hote  irons  or  gaddes  of  stele,  is  excedynge  good  for 
thesame  entent  to  drinke. 

And  here  is  to  be  noted,  that  a  naturall  fluxe  is  never  to  bee  feared 
afore  the  seventh  daye,  and  except  there  issue  bloude,  it  ought  not  to 
bee  stopped  afore  the  sayde  tyme. 

Pouder  of  the  herbe  called  knotgrasse,  or  the  iuce  thereof  in  a  possette 
dronke,  or  a  plaister  of  thesame  herbe,  and  of  bursa  pastoris,  bolearmeny, 
and  the  iuyce  of  plantaine  with  a  Iitle  vyneger,  and  wheate  floure  is 
excedynge  good  for  thesame  cause. 

Also  the  rindle  maw  of  a  young  suckynge  kydde  geven  to  the  chylde, 
the  weight  of  .x.  graines,  with  the  yolke  of  an  egge  soft  rosted,  and  let 
the  pacient  abstayne  from  mylke  by  the  space  of  .ii.  houres  before  and 
after,  in  stede  wherof  ye  maye  geve  a  rosted  quince  or  a  warden  with  a 
Iitle  suger  and  sinamome  to  eate. 


ITEM  AN  OTHER  GOODLY  RECEIT  FOR  THESAME  ENTENT 

Take  sorel  seed,  and  the  kernelles  of  greate  raysyns  dryed,  acorne 
cuppes,  and  the  seed  of  white  popie,  of  eche  .ii.  drammes,  saffron  a  good 
quantytye,  make  them  in  pouder  and  tempre  the  with  the  iuce  of 
quinces,  or  syrupe  of  red  roses,  this  is  a  soverayne  thyng  in  al  fluxes  of 
the  woumbe. 

Many  other  thinges  are  written  of  authours  in  the  sayd  disease, 
whiche  I  here  leave  out  for  brevity:  &  also  by  cause  the  afore  reherced 
medicines  are  sufficiet  ynough  in  a  case  curable:  yet  wyl  I  not  omytte  a 
goodly  practise  in  the  sayde  cure. 

The  pesyl  of  an  hart  or  a  stagge  dryed  in  pouder  and  dronken,  is  of 
great  &  wonderful  effect  in  stoppyng  a  fluxe.  Which  thing  also  is 
approved  in  the  Iy ver  of  a  beast  called  in  Englysshe  an  otter.  The  stones 


182  PEDIATRICS  OF  THE  PAST 

of  him  dronken  in  pouder,  a  little  at  ones  thirty e  daies  togyther,  hath 
healed  men  for  ever  of  the  fallyng  evyl. 

OF  STOPPYNG  OF  THE  BELLYE 

Even  as  a  fluxe  is  daungerous,  so  is  stoppynge  &  hardenesse  of  the 
bellye  grevous  &  noyesome  to  the  chylde,  and  is  often  cause  of  the 
colycke  and  other  diseases. 

Wherfore  in  this  case  ye  must  alway  put  a  Iitle  hony  into  ye  chyldes 
meate,  and  let  the  nource  gyve  hym  honye  to  sucke  upon  her  fynger, 
and  if  this  wil  not  helpe,  then  the  nexte  is  to  myxealytle  fyne  and  cleare 
turpentine,  with  honye,  and  so  to  resolve  it  in  a  saucer,  and  let  the  chylde 
suppe  of  it  a  Iytle. 

This  medicine  is  descrybed  of  Paulus  Agineta,  and  recited  of  dyvers 
other  as  a  thyng  very  holsome  and  agreing  to  the  nature  of  the  child : 
for  it  doeth  not  only  Iosen  ye  bellye  without  grefe  or  daunger,  but  doeth 
also  purge  the  Iyver  and  the  Ionges,  with  ye  splene  and  kidneies,  gen- 
erally comforting  al  the  spiritualll  members  of  the  bodye. 

The  gall  of  an  oxe  or  a  cowe  Iayed  upon  a  cloute  on  the  navylle, 
causeth  a  chyld  to  be  loose  bellyed,  Iykewyse  an  emplayster  of  a  rosted 
onyon,  the  gall  of  an  oxe,  &  butter,  Iayed  upon  the  belye  as  hote  as  he 
maye  suffre.  Yf  these  wyl  not  helpe,  ye  shal  take  a  Iytle  cotten,  and  roll 
it,  and  dypped  in  the  sayd  gall,  put  it  in  the  fundament. 

OF  WORMES 

There  be  dy verse  kindes  of  wormes  in  ye  belly,  as  Ionge,  short,  rounde, 
flat,  and  some  small  as  Iyce,  they  be  al  engendred  of  a  crude,  grosse,  or 
phlegmatike  mater,  &  never  of  choler  nor  of  melancholy,  for  al  bytter 
thynges  kylleth  them,  &  al  swete  meates  that  engendre  fleume,  nourissh- 
eth  and  fedeth  the  same.  The  signes  dyffer  according  to  ye  wormes. 
For  in  the  long  &  roud,  the  paciet  comonly  hath  a  drye  cough,  paine  in 
the  belly  about  ye  guttes,  som  tyme  yeaxing  &  trebling  in  ye  nighte,  & 
starte  sodaynely,  and  fal  aslepe  againe,  other  whyles  they  gnasshe  and 
grynd  theyr  teeth  togither,  the  eies  waxe  hollowe  with  an  eygre  Ioke,  & 
have  great  delyte  in  slombryng,  and  sylence,  very  loth  whe  they  are 
awaked.  The  pulse  is  incertayne,  and  never  at  one  staye,  sometyme  a 
fever  with  greate  colde  in  ye  ioyntes,  which  endureth  thre  or  .iiii.  houres 
in  the  night  or  day,  many  have  but  small  desire  to  meate,  and  when  they 
desyre,  they  eate  very  greedelye,  which  yf  they  Iacke  at  theyr  appetyte, 
they  forsake  it  a  great  whyle  after,  the  hole  body  cosumeth  and  waxeth 
Ieane  the  face  pale  or  blewe:  somtime  a  fluxe,  somtimes  vomite,  and  in 
some  the  belye  is  swollen  as  styffe  as  a  taberet.  The  long  and  brode 
wormes  are  knowen  by  these  sygnes,  that  is  to  say,  by  yelownesse  or 


THOMAS  PHAER  183 

whittishnesse  of  ye  eyes,  intollerable  hunger,  greate  gnawinge  and  gryp- 
yng  in  the  belly,  specially  afore  meat,  water  commyng  out  at  the  mouth, 
or  at  ye  foundement,  continuall  ytche  and  rubbing  of  the  nosethrilles, 
sonken  eies  and  a  stynkyng  breath,  also  when  the  person  doth  his  ease- 
ment, there  appeareth  in  the  donge  Iytle  flat  substaunces,  moche  Iyke 
the  seedes  of  cucumers  or  gourdes. 

The  other  Iesse  sorte  are  engendred  in  the  great  gutte,  &  may  wel  be 
knowen  by  the  excedyng  ytche  in  the  fundament  within,  &  are  oftentimes 
sene  commyng  out  with  the  excrementes.  They  be  called  of  phisicios, 
ascarydes. 

REMEDY  FOR  WORMES  IN  CHYLDREN 

The  herbe  that  is  founde  growyng  upon  oisters  by  the  seas  syde,  is 
a  synguler  remedy  to  destroye  wormes,  and  is  called  therfore  of  ye  Grekes 
Scolytabotant,  that  is  to  say,  the  herbe  that  kylleth  wormes:  it  muste  be 
made  in  pouder,  and  gyven  with  sweate  milke  to  the  chylde  to  drynke. 
The  Phisicions  call  the  same  herbe  coralino. 

A  SINGULER  RECEYTE  FOR  TO  KYLL  WORMES 

Take  the  gall  of  a  bull  or  oxe,  newlye  kylled,  and  stampe  in  it  an 
handful  of  good  comyne,  make  a  playstre  of  it,  and  lay  it  over  all 
the  belly,  removing  the  same  every  fyve  houres. 

Item  the  gall  of  a  bull  with  seedes  of  colocinthis,  called  colloquintida 
of  the  pothecaryes,  and  an  handfull  of  baye  beries  wel  made  togither  in  a 
plaister,  with  a  sponful  of  strong  vinegre,  is  of  greate  effecte  in  the  same 
case. 

Yf  the  childe  be  of  age  or  strong  complexion,  ye  may  make  a  fewe 
pilles  of  aloes,  and  the  pouder  of  wormeseed,  then  wynd  them  in  a  pece  of 
a  singing  Iofe,  and  annoynte  them  over  with  a  Iytle  butter:  and  let  the  be 
swalowed  downe  hole  without  chewyng. 

OF  SWELLYNG  OF  THE  NAVILL 

In  a  child  lately  borne,  and  tender,  somtyme  bycuttyngofthenavyll 
to  nere,  or  at  an  inconveniente  season,  somtyme  by  swadlynge  or 
byndynge  amysse,  or  of  moche  cryinge,  or  coughynge,  it  happeneth 
otherwhyles,  that  the  navyll  aryseth  and  swelleth  with  great  paine  and 
apostemacion,  the  remedy  wherof  is  not  muche  differente  from  the  cure 
of  ulcers,  savynge  in  thys  that  ye  oughte  to  applye  thynges  of  Iesse  attrac- 
tion, then  in  other  kind  of  ulcers,  as  for  an  example,  ye  maye  make  an 
oyntmente  under  thys  fourme. 

Take  spike  or  lavender,  halfe  an  ounce,  make  it  in  pouder,  and  wyth 
thre  ounces  of  fyne  and  cleare  turpentyne,  tempre  it  in  an  oyntmente, 


1 84  PEDIATRICS  OF  THE  PAST 

addying  a  portion  of  oyle  of  swete  almons.  But  yf  it  come  of  cryinge, 
take  a  Iytle  beane  floure,  and  the  asshes  of  fyne  Iynnen  cloutes  brent, 
and  tempre  it  with  redde  wine  and  honye,  and  Iaye  it  to  the  sore. 

A  PLAYSTER  FOR  SWELLYNG  IN  THE  NAVILL 

TaJce  cowes  donge,14  and  drye  it  in  poudre,  barlye  floure,  and  beane 
floure  of  eche  a  porcion,  the  iuyce  of  knotgrasse  a  good  quantitie,  comine 
a  Iitle,  make  a  playster  of  all  and  set  it  to  the  navyl. 

AN  OTHER 

Take  cowes  donge  and  seeth  it  in  the  mylke  of  the  same  cowe,  and 
lay  it  On  the  grefe.  This  is  also  marveylouse  effectuall  to  helpe  a  soodayne 
ache,  or  swelling  in  the  Iegges. 

OF  THE  STONE  IN  CHYLDREN 

The  tender  age  of  children  as  I  sayd  afore,  is  vexed  and  afflicted  with 
manye  grevous  and  peryllous  diseases,  amog  who  there  is  fewe  or  none  so 
violente  or  more  to  be  feared  in  them,  then  that  whiche  is  most  feared 
in  al  kindes  of  ages,  that  is  to  say,  the  stone,  an  houge  and  a  pityful 
disease,  ever  the  more  enereasyng  in  dayes,  ye  more  rebelling  to  the  cure 
of  Physycke, 

Therfore  is  it  excedyng  daungerouse  whan  it  falleth  in  children,  for 
asmoch  as  neither  the  bodyes  of  them  may  be  wel  purged  of  the  matter 
antecedent,  called  humor  peccans,  nor  yet  ca  abide  any  vyolent  mede- 
cyne  hauing  power  to  breake  it,  by  reason  wherof  the  said  dysease 
acquyreth  suche  a  strengthe  above  nature,  that  in  processe  of  time  it  is 
utterlye  incurable. 

Yet  in  the  begynning  it  is  oftentimes  healed  thus. 

Fyrste  Iette  the  nurse  be  well  dyeted,  or  the  chyld,  yf  it  be  of  age, 
abstaining  from  al  grosse  meates,  and  hard  of  digestion,  as  is  beafe, 
bacon,  salt  meates  and  cheese,  than  make  a  pouder  of  the  roote  of  peonye 
dryed,  and  myngle  it  with  as  muche  hony  as  shal  be  sufficient,  oryf  the 
child  abhorre  hony,  make  it  up  with  suger  molten  a  Iytle  upon  the  cooles, 

14  From  the  earliest  times  many  agents  used  as  medicines  have  been  objectionable 
both  as  to  origin  and  physical  propreties.  The  proprieties  and  the  eternal  fitness  of 
things  are  easily  forgotten  in  the  quest  for  panaceas,  and  the  idea  that,  as  medicines 
were  obnoxious,  the  otherwise  objectionable  must  perforce  be  efficacious  in  human 
therapeutics.  This  idea  culminated  in  the  London  Pharmacopaeias  bearing  the  dates 
of  1618,  1650,  1677  an<3  1 72 1.  Since  then,  fortunately,  the  tendency  has  been  to  swing 
away  at  least  from  the  excrementitious,  and  though  we  laugh  at  powdered  hog's  lice, 
we  swallow  tons  of  synthetic  chemicals,  many  objectionable  poisons  and  go  in  for 
indiscriminate  vaccines  and  serums  because  a  few  are  really  efficacious. 


THOMAS  PHAER  185 

and  gyve  thereof  unto  the  chylde,  more  or  Iesse,  accordinge  to  the 
strengthe,  twyse  a  daye,  tylle  ye  se  the  uryne  passe  easelye,  ye  maye  also 
give  it  in  a  rere  egge,  for  without  dout  it  is  a  syngulef  remedye 
in  chyldren. 

AN  OYNTMENT  FOR  THE  SAME 

Oyle  of  scorpions,  yf  it  may  be  gotten,  is  exceding  good  to  annoint 
withal  the  membres,  and  the  nether  parte  of  the  bellye,  ryghte  agaynst 
the  bladder,  ye  may  have  it  at  the  pothecaries. 

A  SINGULER  BATH  FOR  THE  SAME  ENTENT 

Take  mallowes,  holyhocke,  Iyly  rootes,  Iynseed,  and  parietary  of  the 
wal,  seeth  them  all  in  the  broth  of  a  shepes  head,  and  therin  use  to  bathe 
the  chyld  oftentymes,  for  it  shal  open  the  straytnes  of  the  condites,  that 
the  stone  may  issue,  swage  the  payne,  and  brynge  out  the  gravel  with  the 
urine,  but  in  more  effect  whan  a  playster  is  made,  as  shal  be  sayde  her- 
after,  and  Iayed  upon  the  raynes,  and  the  belly,  immediatly  after  the 
bathyng. 

A  PLAYSTER  FOR  THE  STONE 

Take  parietarie  of  the  wal,  one  portion,  and  stampe  it,  doves  donge 
an  other  porcion,  and  grynde  it,  than  frye  the  both  in  a  panne,  with  a 
good  quatitye  of  freshe  butty  re,  and  as  hote,  as  may  be  suffered,  lay  it 
to  the  belly  and  the  backe,  and  from  .iiii.  houres  to  .iiii  let  it  be  renewed. 

This  is  a  soverayne  medicine  in  all  maner  ages. 

Item  an  other  pouder  whiche  is  made  thus. 

Take  the  kernels  or  stones  that  are  found  in  the  fruyte,  called  openers 
or  mespiles,  or  of  some,  medlars. 

Make  them  in  fine  pouder,  whiche  is  wounderfull  good  for  to  breake 
the  stone  without  daunger,  both  in  yonge  and  olde. 

The  chestwormes  dryed  and  made  in  fyne  pouder,  taken  with  the 
brothe  of  a  chycken,  or  a  Iytle  suger,  helpeth  them,  that  can  not  make 
theyr  uryne. 

OF  PYSSYNG  IN  THE  BEDDE 

Many  times  for  debility  of  vertue  retentive  of  the  reines  or  blader,  as 
wel  olde  me  as  children  are  oftentimes  annoyed,  whan  their  urine  issueth 
out  either  in  theyr  slepe  or  waking  against  theyr  wylles,  having  no  power 
to  reteine  it  whan  it  cometh,  therfore  yf  they  will  be  holpe,  fyrst  they 
must  avoid  al  fat  meates,  til  ye  vertue  retentive  be  restored  againe,  and 
to  use  this  pouder  in  their  meates  and  drynkes. 


1 86  PEDIATRICS  OF  THE  PAST 

Take  the  wesande  [trachea]  of  a  cocke,  and  plucke  it,  tha  brenne  it 
in  pouder,  and  use  of  it  twise  or  thryes  a  daye.  The  stones  of  an  hedge- 
hogge  poudred  is  of  the  same  vertue. 

Item  the  clawes  of  a  goate,  made  in  pouder  dronken,  or  eaten 
in  pottage. 

If  the  pacient  be  of  age,  it  is  good  to  make  fyne  plates  of  Ieade,  with 
holes  in  them,  and  Iette  them  lye  often  to  the  naked  backe. 

OF  BRUSTYNGE  [HERNIA] 

The  causes  of  it  in  a  childe  are  many,  for  it  may  come  of  very  Iyghte 
occasions,  as  of  greate  crying,  &  stopping  the  breathe,  byndyng  to 
stray ghte,  or  by  a  fal,  or  of  to  greate  rocky ng,  and  such  lyke,  may  cause 
the  filme  that  spreadeth  over  the  belly,  to  breake  or  to  flacke,  and  so  the 
guttes  fall  downe,  into  the  cod,  which  yf  it  be  not  utterly  uncurable,  may 
be  healed  after  thys  sorte. 

Fyrste  Iaye  the  paciente  so  upon  his  backe,  that  hys  heade  maye  be 
lower  than  his  heales,  than  take  and  reduce  the  bowels  with  youre 
hande,  into  the  due  place,  afterwarde  ye  shall  make  a  playster  to  be  Iayde 
upon  the  coddes,  and  bounde  with  a  lace  round  aboute  the  backe,  after 
this  fourme. 

Take  rosin,  frankynsence,  mastyke,  comyne,  Iyneseed,  &  anyse  seed, 
of  every  one  a  lyke,  pouder  of  osmonde  rootes  [a  sort  of  fern,  King  Fern], 
that  is  to  saye,  of  the  brode  feme,  ye  .iiii.  parte  of  al,  make  a  plaister  with 
sufficient  oyle  olyve,  and  fresshe  swynes  grece,  and  sprede  it  on  a  Iether, 
and  let  it  cotinue  (except  a  great  necessity)  two  or  thre  wekes,  after  that 
applye  an  other  lyke,  tyll  ye  see  amendment.  In  thys  case  it  is  verye 
good  to  make  a  poudre  of  the  heares  of  an  hare,  &  to  temper  it  with 
sugre  or  conserva  roses  and  give  it  to  the  child  twies  every  daye. 

If  it  be  above  the  age  of  .vii.  yere,  ye  may  make  a  singuler  receyte  in 
drinke  to  be  taken  everye  daye  twyse,  thus. 

A  DRYNKE  FOR  ONE  THAT  IS  BROSTEN 

Take  matselon,  dayses,  comfery,  and  osmundes,  of  everye  one 
lyke,  seeth  them  in  the  water  of  a  smythes  forge,  to  the  third  part,  in 
a  vessel  covered,  on  a  soft  fyer,  than  strayne  it  and  gieve  to  drynke  of  it, 
a  good  draughte  at  ones,  mornyng  and  evenynge,  addyng  evermore  in  his 
meates  and  drinkes,  the  pouder  of  the  heare  of  an  hare,  beynge  dryed. 

OF  FALLYNG  OF  THE  FUNDAMENT 

Many  times  it  happeneth  that  the  gut  called  of  the  Iaties  rectum 
intestinu,  falleth  out  at  the  fudament,  &  can  not  be  gotten  in  againe 


THOMAS  PHAER  187 

wythoute  peyne  and  labour,  whiche  disease  is  a  common  thynge  in 
children,  comming  oftentimes  of  a  sodayne  cold  or  a  long  Iaxe,  and  maye 
well  be  cured  by  these  subscribed  medicines. 

If  the  gutte  hath  ben  Ionge  out,  and  be  so  swollen  that  it  clnot  be 
reposed,  or  by  coldnes  of  the  ayre  be  congeled,  the  best  counsell  is  to  let 
the  child  sit  on  a  hote  bathe,  made  of  the  decoccion  of  mallowes,  holi- 
hocke,  Iineseed,  and  the  rootes  of  Iyllyes,  wherin  ye  shall  bathe  the  funda- 
mente,  wyth  a  softe  cloute  or  a  sponge,  and  whan  the  place  is  suppled 
thruste  it  in  agayne,  whiche  done,  than  make  a  pouder  thus. 

A  POUDER  FOR  FALLYNG  OF  THE  FOUNDAMENT 

Take  the  poudre  of  an  hartes  home  brent,  the  cuppes  of  acornes 
dried,  rose  leaves  dryed,  goates  clawes  brent,  the  rinde  of  a  pomegranate, 
and  of  galles,  of  everye  one  a  portion.  Make  them  in  pouder,  and  strowe  it 
on  the  fundament.  It  shal  be  the  better,  yf  ye  put  a  Iytle  on  the  gutt, 
afore  it  be  reposed  in  ye  place,  &  after  it  be  setled,  to  put  more  of  it  upon 
the  fudament,  than  binde  it  in  with  hotte  Iynnen  clothes,  and  gyve  the 
childe  quynces,  or  a  rosted  warden,  to  eate  with  cinamome  and  suger. 

AN  OTHER  GOOD  POUDER  FOR  THE  SAME 

Take  galles,  myrre,  frankensence,  mastike,  and  aloes,  of  every  one  a 
Iitle,  make  them  in  pouder,  and  strowe  it  on  the  place. 

A  Iytle  tarre  with  gosegrese  is  also  very  good  in  this  case. 

AN  OTHER  GOOD  REMEDYE 

Take  the  wolle  from  betwene  the  Iegges,  or  of  ye  necke  of  a  shepe, 
which  is  full  of  sweate  and  fattie  [Lanolin],  than  make  a  iuce  of  unsette 
Ieekes,  and  dippe  the  wolle  in  it,  and  Iaye  it  to  the  place  as  whotte,  as 
may  be  suffered,  and  whan  it  waxeth  cold  remove  it  and  apply  an  other 
hote,  this  is  a  very  good  remedy  for  fallynge  of  the  fundament. 

If  the  chylde  provoke  many  tymes  to  seege,  and  can  expell  nothynge, 
that  dysease  is  called  of  the  Grekes  tenesmoos,  for  the  whiche  it  shall 
be  verye  good  to  apply  a  playster  made  of  gardein  cressis  &  a  comine  in 
Iyke  quatitye,  frye  them  in  butter,  and  Iaye  it  on  the  bellye  as  hote  as  he 
maye  suffer. 

It  is  also  commended,  to  fume  the  nether  partes  with  turpentine  and 
pitch,  and  to  sit  Ionge  upon  a  bourd  of  ceder  or  iuniper,  as  maye  be 
possible. 

CHAFYNG  OF  THE  SKYNNE 

In  the  flankes,  armeholes,  &  under  the  eares,  it  chaunceth  often  times 
that  the  skynne  fretteth,  ether  by  the  childes  own  uryne,  or  for  the  defaute 


x88  PEDIATRICS  OF  THE  PAST 

of  washyng,  or  els  by  wrappyng  and  kepyng  to  hote.  Therefore  in  the 
begynnyng,  ye  shall  annoint  the  places,  with  freshe,  capons  grece,  then 
yf  it  wyll  not  heale,  make  an  oyntment,  and  Iaye  it  on  the  place. 

AN  OYNTMENT  FOR  CHAFYNG  AND  GALLYNG 

Take  the  roote  of  floure  deluyce  dryed,  of  redde  roses  dryed,  gal- 
ingale,  and  mastike,  of  eche  a  Iyke  quantytye,  beate  them  into  moste 
subtyle  pouder:  than  with  oyle  of  roses,  or  of  Iineseede,  make  a  soft 
oyntment. 

Item  the  Ionges  [lungs]  of  a  wether  dryed,  and  made  in  very  fyne 
pouder,  healeth  al  chafynges  of  the  skinne,  and  in  Iyke  maner  the  frag- 
ments of  shomakers  Iether,  brent  and  cast  upon  the  place,  in  as  fine  pouder 
as  is  possible,  hath  the  same  effecte,  whiche  thing  is  also  good  for  the 
galling  or  chafing  of  the  fete,  of  whatsoever  cause  it  commeth. 

Item  beane  floure,  barly  floure,  and  the  floure  of  fitches  tempered  with 
a  Iytle  oyle  of  roses,  maketh  a  soveraine  ointment  for  thesame  entent. 

If  the  chafinges  be  great,  it  is  good  to  make  a  bath  of  holihocke,  dyll, 
violets  and  Iineseede  with  a  litle  branne,  than  to  washe  thesame  places 
oftentymes,  and  lay  upon  the  sore,  some  of  thesame  thinges.  The  decoc- 
tion of  plantaine,  bursa  pastoris,  horsetaile  and  knotgrasse,  is  exceadynge 
good  to  heale  all  chafynges  of  the  skynne. 

OF  SMALL  POCKES  AND  MEASILES 

This  disease  is  common  &  familier,  called  of  ye  grekes  by  the  general 
name  of  exanthemata,  and  of  plinie,  papule  et  pituite  erupciones,  not- 
withstanding ye  cosent  of  writers,  hath  obteined  a  distinctio  of  it  in  .ii. 
kindes:  that  is  to  saye,  varioli  the  measils,  and  morbilli  called  of  us  the 
smal  pockes.  They  bee  bothe  of  one  nature,  and  procede  of  one  cause, 
savin ge  that  the  measils  are  ingendred  of  the  inflamacion  of  bloude,  and 
the  small  pockes  of  the  inflammacion  of  bloude  myngled  with  cholere. 

The  sygnes  of  them  bothe  are  so  manyfeste  to  syghte,  that  they 
nede  no  farther  declaracyon,  for  at  the  fyrste,  some  have  an  ytche  and  a 
freting  of  the  skynne  as  yf  it  hadde  bene  rubbed  wyth  nettles,  payne  in 
the  heade  and  in  the  backe,  the  face  redde  in  coloure  and  flecked,  feare  in 
the  sleepe,  greate  thyrst,  rednesse  of  the  eyes,  beatynge  in  the  temples, 
shotynge  and  pryckyng  thorough  all  the  bodye,  then  anone  after,  when 
they  breake  out,  they  bee  sene  of  dy vers  fashions  and  fourmes,  sometimes 
as  it  were  a  drye  scabbe  or  a  Iepry  spredyng  over  all  the  members,  other 
whiles  I  pushes,  pimples,  and  wheles,  rennyng  with  much  corrupcion  and 
matter,  and  with  great  peine  of  the  face  and  throte,  drines  of  the  toungue, 
horcenes  of  voyce,  and  in  some  quiverynge  of  the  hearte  with  swownyng. 

The  causes  of  these  evil  affeccions,  are  rehersed  of  authours,  to  be 
chiefly  .iiii.  Fyrst  of  the  superfluities  which  might  be  corrupt  in  the  womb 


THOMAS  PHAER  189 

of  the  mother,  the  chylde  there  beyng,  and  receivinge  thesame  into  the 
poores,  the  whiche  at  that  tyme  for  debility  of  nature,  could  not  be 
expelled,  but  ye  chyld  encresyng  afterward  in  strength,  bee  dryven  out 
of  the  veines  into  the  upper  skynne. 

Secondarilye  it  maye  come  of  a  corrupt  generacion,  that  is  to  saye, 
whan  it  was  engendred  in  an  evyll  season,  ye  mother  being  sycke  of  her 
naturall  infyrmity,  for  such  as  are  begotten  that  tyme  verye  seldome 
escape  the  disease  of  Ieprye. 

The  thyrde  cause  maye  be  an  evyll  dyete  of  the  nurse,  or  of  the  chylde 
it  self,  whan  they  fede  upon  meates  that  encrease  rotten  humours,  as 
mylke  and  fyshe  both  at  one  meale,  Iykewyse  excesse  of  eating  and 
drinking,  and  surfeitte. 

Fourthly  this  disease  commeth  by  the  waye  of  contagion,  whan  a 
sycke  person  infecteth  an  other,  and  in  that  case  it  hath  great  affinitie 
with  the  pestilence. 


REMEDY 

The  beste  and  most  sure  help  in  this  case,  is  not  to  meddle  with  anye 
kynde  of  medicines,  but  to  let  nature  worke  her  operacion,  notwyth- 
standynge  yf  they  be  to  slowe  in  commyng  oute,  it  shal  be  good  for  you 
to  geve  the  childe  to  drinke,  sodden  mylke  and  saffron,  &  so  kepe  hym 
close,  and  warme,  wherby  they  may  the  soner  issue  foorth,  but  in  no  case 
to  administer  any  thynge  that  myght  eyther  represse  the  swelling  of  the 
skinne,  or  to  coole  the  heate  that  is  within  the  members.  For  yf  this 
dysease  which  shuld  be  expelled  by  a  natural  accion  of  ye  body  to  ye 
long  health  afterward  of  the  pacient,  wer  by  force  of  medicin  cowched  in 
againe,  it  wer  eve  inough  to  destroy  the  child.  Therfore  abide  ye  ful 
breaking  out  of  ye  said  wheales,  and  then  (if  they  be  not  ripe)  ease  the 
childes  peyne  by  makynge  a  bath  of  holihock,  dyl,  camomil  &  fenel :  if 
thei  be  ripe  &  matter,  the  take  fenel,  wormewood  and  sage,  and  seeth 
them  in  water,  to  the  thirde  part,  wherin  ye  maye  bathe  him  with  a 
fine  cloth  or  a  sponge.  Alwaies  provided  ye  he  take  no  cold  duryng 
the  time  of  his  sickenesse.  The  wyne  wherein  fygges  have  been  sod,  is 
singuler  good  in  thesame  case,  &  may  be  wel  used  in  all  times  &  causes. 

Yf  the  wheales  bee  outragious  and  great,  with  much  corrosio  and 
venime,  some  make  a  decoction  of  roses  &  plataine,  in  the  water  of  oke, 
and  dissolve  in  it  a  Iitle  englishe  hony  &  camphore.  The  decoction  of 
water  betonye,  is  approved  good  in  the  sayed  diseases.  Likewise  ye 
ointment  of  herbes,  wherof  I  made  mencio  I  ye  cure  of  scabbes,  is  exced- 
ing  holsome  after  the  sores  are  rype. 

Moreover  it  is  good  to  droppe  in  the  pacientes  eyes  .v.  or  vi.  tymes 
a  daye,  a  Iitle  rose  or  fenell  water,  to  coumforte  the  syght,  Ieste  it  be 


ipo  PEDIATRICS  OF  THE  PAST 

hurte  by  continual  rennig  of  matter.  This  water  must  be  ministred 
in  the  sommer  colde,  &  in  the  wlter  ye  ought  to  apply  it  Iuke  warme. 

Thesame  rose  water  is  also  good  to  gargle  in  his  mouth,  yf  the  chylde 
bee  then  payned  in  the  throte. 

And  lest  the  condites  of  ye  nose  should  be  stopped,  it  shalbe  very 
expedient  to  let  him  smel  often  to  a  sponge  wete  in  the  iuce  of  saverye, 
strong  vineger,  and  a  Iitle  rose  water. 

TO  TAKE  AWAY  THE   SPOTTES  AND  SCARRES   OF  THE  SMAL  POCKES 

AND  MEASILS 

The  bloude  of  a  bull  or  of  an  hare  is  much  commeded  of  authours 
to  be  annointed  hote  upon  the  scarres,  &  also  ye  licour  ye  issueth  out  of 
shepes  clawes  or  goates  clawes  het  in  the  fier.  Item  the  dripping  of  a 
cignet  or  swanne  laid  upon  the  places  oftentimes  hote. 

FEVERS 

If  the  fever  use  to  take  the  chylde  with  a  great  shaky ng,  and  after- 
warde  hote,  whether  it  be  cotidian  or  tercian,  it  shall  be  singuler  good  to 
geve  it  in  drinke,  the  blacke  seedes  of  peony  made  in  fine  pouder,  searced 
and  mingled  with  a  Iitle  suger. 

Also  take  plaintain,  fetherfew  and  veruein,  and  bath  the  chyld  in  it 
once  or  twyse  a  daye,  binding  to  the  pulces  of  the  handes  and  fete  a 
plaister  of  yesame  herbes  stamped,  and  provoke  the  child  to  sweate 
afore  the  fitte  commeth. 

Some  geve  counsell  in  a  hote  fever,  to  apply  a  colde  plaister  to  the 
breast,  made  in  this  wyse.  Take  the  iuyce  of  wormewood,  plantain, 
mallowes  and  housleke,  and  temper  in  them  asmuche  barly  floure  as 
shal  bee  sufficiente,  and  use  it.  Or  thus,  and  more  better  in  a  weake 
paciente. 

Take  drye  roses  and  pouder  them,  then  temper  the  pouder  with  the 
iuice  of  endive  or  purcelane,  rose  water,  and  barly  floure,  and  make  a 
plaister  to  the  stomake. 

Item  an  ointmente  for  hys  temples  armes  and  Iegges,  made  of  oyle  of 
roses,  and  populeon,  of  eche  like  muche. 

A  GOOD  MEDICINE  FOR  THE  AGUE  IN  CHILDREN 

Take  plantaine  with  the  roote,  and  wash  it,  then  seeth  it  in  fayre 
runnyng  water  to  the  thirde  part:  whereof  ye  shal  geve  it  a  draught 
(yf  it  bee  of  age  to  drinke)  with  sufficiente  suger,  &  Iaye  the  sodden 
herbes  as  hote  as  maye  be  suffred,  to  the  pulses  of  the  handes  and  fete. 
Thys  must  be  doneV  Iitle  afore  ye  fit,  &  afterward  cover  it  with  clothes. 


THOMAS  PHAER  191 

The  oyle  of  nettles  wherof  I  spake  in  the  title  of  stifnes  of  Iimmes,  is 
exceding  good  to  annointe  the  members  in  a  colde  shaking  ague. 

OF  SWELLING  OF  THE  CODDES 

To  remove  the  swellynge  of  the  coddes,  procedyng  of  ventositye, 
or  of  any  other  cause  (except  brustyng),  whether  it  be  with  inflammacio 
or  without,  here  shalbe  rehersed  many  good  remedies,  of  whiche  ye  maye 
use,  according  to  the  quality  and  quantitye  of  the  griefe:  alwaye  pro- 
vided ye  in  this  disease,  ye  maye  in  no  case  applye  any  repercussives, 
that  is  to  saye,  set  no  colde  herbes  to  drive  the  matter  backe,  for  it  would 
than  returne  again  into  the  bodye,  and  the  congelacion  of  such  a  sinowye 
member,  would  paradventure  mortifye  the  hole.  And  above  al  ye  may 
set  no  plaister  to  the  stones,  wherein  humlocke  entreth,  for  it  wyll  deprive 
the  for  ever  of  their  growing  &  not  only  the,  but  the  brestes  of  wenches, 
wha  they  be  annointed  therwith  by  a  certain  quality,  or  rather  an  evyl 
propertye  beyng  in  it. 

A  GOODLY  PLAISTER  FOR  SWELLING  OF  THE  STONES 

Take  a  quart  of  good  ale  woort  and  sette  it  on  the  fyer  to  seeth,  wyth 
the  crommes  of  browne  breade  stronglye  Ievened,  and  a  handefull  of 
comine  or  more  in  pouder,  make  a  playster  wyth  al  this  and  sufficient 
beane  floure,  and  applye  it  to  the  gryefe,  as  hote  as  may  be  suffered. 

AN  OTHER 

Take  cowes  donge,  and  seeth  it  in  mylke,  than  make  a  playster,  and 
Iaye  it  metely  hote  upon  the  swelling. 

AN  OTHER 

Take  comine,  anyseseede,  and  fenugreke,  of  eche  a  like  porcion, 
seeth  them  in  ale  and  stampe  them,  then  temper  them  with  freshe  maye 
butter,  or  a  Iytle  oyle  olyve,  and  apply  it  to  the  sore. 

AN  OTHER 

Take  camomyl,  holihocke,  Iynseede  and  fenugreke,  seeth  them  in 
water,  &  grynde  all  together,  then  make  a  plaister  with  an  handefull  of 
beane  floure,  and  use  it. 

AN  OTHER  IN  THE  BEGINNING  OF  THE  GRIEFE 

Yf  there  be  muche  inflamacion  or  heate  in  the  coddes,  ye  may  make 
an  oyntment  of  plaintaine,  the  whyte  and  yolke  of  an  egge,  and  a  porcion 


i92  PEDIATRICS  OF  THE  PAST 

of  oyle  of  roses,  styrre  them  wel  aboute,  &  applye  it  to  ye  grefetwiseor 
thrise  a  day. 

When  the  paine  is  intollerable,  and  the  child  of  age,  or  of  strong 
complexion,  yf  the  premisses  will  not  helpe,  ye  shal  make  a  plaister  after 
this  sorte. 

Take  henbane  leaves,  an  handful  and  an  halfe,  mallowe  leaves, 
an  handfull,  seeth  them  well  in  cleare  water,  then  stampe  them  and 
styrre  them,  and  with  a  Iitle  of  the  brothe,  beane  floure,  barly  floure, 
oyle  of  roses  and  camomyl  sufficient,  make  it  up  and  set  on  the  swelling 
luke  warme.  Henbane  as  Avicen  [Avicenna]  sayth,  is  excedynge  good  to 
resolve  the  hardnes  of  the  stones  by  a  secret  qualitye.  Notwithstandyng, 
yf  it  come  of  winde,  it  shalbe  better  to  use  the  sayde  plaisters  ye  are 
made  with  comine,  for  that  is  of  a  singuler  operacio  in  dissolving  winde, 
as  affirmeth  Dioscorides  writyng  of  the  qualities  of  cumine. 

OF  SACER  IGNIS  OR  CHINGLES 

In  Greke  herisipelas,  and  of  the  Latines  Sacer  ignis,  oure  Englishe 
women  cal  it  the  fyre  of  Saynt  Anthony,  or  chingles,  it  is  an  inflammacion 
of  members  wyth  exceding  burnynge  and  rednesse,  harde  in  the  feelyng, 
and  for  the  moste  parte  crepeth  above  the  skynne  or  but  a  Iytle  depe 
within  the  fleshe. 

It  is  a  grievous  paine,  &  may  be  likened  to  the  fyre  in  consuming. 
Wherefore  the  remedies  ye  are  good  for  burning  are  also  very  holesome 
here  I  this  case.  And  fyrste  the  grene  ointment  of  herbes  discribed  in  ye 
chapter  of  itche,  is  of  good  effect  also  in  this  cure :  more  over  ye  medicines 
ye  are  here  discribed.  Take  at  the  pothecaries  of  unguent u  Galeni  an 
ounce  and  an  halfe,  oyle  of  roses  two  ounces,  unguenti  populeon  one 
ounce,  ye  iuce  of  plantain,  &  nightshade  one  ounce  or  more,  the  whites  of 
iii.  egges,  heat  the  altogether,  &  ye  shal  have  a  good  ointmet  for  the  same 
purpose. 

AN  OTHER 

Take  earthwormes  and  stampe  them  in  vineger,  then  annoint  the 
grefe  every  two  houres. 

Item  ye  donge  of  a  swan,  or  in  Iacke  of  it  the  donge  of  a  gose  stamped 
with  the  whyte  and  yolke  of  an  egge,  is  good. 

Item  doves  donge  stamped  in  salet,  oyle  or  other,  is  a  singuler  remedy 
for  thesame  purpose. 

OF  BURNYNG  AND  SCALDING 

For  burning  and  scalding  whether  it  be  with  fier,  water,  oile,  Ieade, 
pytch,  lime,  or  any  suche  infortune:  Ye  must  beware  ye  set  no  repercus- 


THOMAS  PHAER  193 

sive  at  ye  fyrst,  that  is  to  saye  no  medicine  of  extreme  colde,  for  that 
might  chaunce  to  drive  the  fervet  heat  into  the  sinowes  and  so  stoppe  the 
poores,  that  it  could  not  issue,  whereof  should  happen  much  incon- 
venience in  a  great  burnyng  (but  in  smal  it  coulde  not  be  so  daungerous:) 
wherfore  ye  best  is  when  ye  see  a  member  eyther  brent  or  scalded,  as  is 
sayde  afore. 

Take  a  good  quantitie  of  brine,  which  is  made  of  water  and  salt, 
not  to  excedyng  eyger  or  stronge,  but  of  a  meane  sharpnes,  and  with  a 
clout  or  a  sponge  bathe  the  member  in  it  colde,  or  at  the  least  bloud 
warm,  thre  or  foure  houres  together,  the  longer  the  better:  For  it  shall 
asswage  muche  of  the  peine,  open  the  pores,  cause  also  the  fyer  to 
vapour,  and  geve  a  great  comfort  to  the  weake  member.  The  annoint 
the  place  with  one  of  these  medicines. 

Take  oyle  of  roses  one  parte,  swete  creme  two  partes,  hony  halfe  a 
parte,  make  an  oyntment  and  use  it. 

Item  all  the  medicines  described  in  the  last  chapter,  are  of  greate 
effecte  in  this  case,  Iikewyse  the  grene  ointment  made  of  water  betonye. 

Item  a  soveraine  medicine  for  burnynge  and  scaldynge,  and  all 
unkynde  heates  is  thus  made.  Take  a  dosen  or  more  of  hard  rosted  egges, 
and  put  the  yolkes  in  a  pot  on  the  fyer  by  the  self,  without  Iicour,  styree 
them  and  braye  them  with  a  strong  hand,  tyll  there  aryse  as  it  wer  a 
froth  or  spume  of  oyle  to  the  mouth  of  the  vessell,  then  presse  the  yolkes 
and  reserve  the  Iicour,  this  is  called  oile  of  egges :  a  very  precious  thyng 
in  the  foresayde  cure. 

Moreover  ther  is  an  oyntment  made  of  sheepes  dounge  fryed  in  oyle 
or  in  swines  grece,  than  putte  to  it  a  Iitle  waxe,  and  use  it. 

Also  take  quicke  lime  and  washe  it  in  veriuce  .ix.  or  .x.  tymes,  than 
mingle  it  with  oile,  &  kepe  it  for  thesame  entent.  Item  the  iuyce  of  the 
leaves  of  Lylyes  .v.  partes,  and  vineger  one  parte,  hony  a  Iytle,  maketh 
an  excellent  medicine,  not  onely  for  this  entent,  but  for  al  other  kynd  of 
hote  and  runnyng  ulcers. 

Note  that  whatsoever  ye  use  in  thys  case,  it  must  be  laid  unto, 
bloud  warm.  Also  for  avoydyng  of  a  scarre,  kepe  the  sore  alwaye  moyste 
with  medicine. 

OF  KYBES    [CHILBLAINS] 

The  kybes  of  ye  heeles,  are  called  in  Iatyne  perniones,  they  procede 
of  cold,  &  are  healed  with  these  subscribed  remedies.  A  rape  rote,  rosted 
wyth  a  Iitle  fresh  butter,  is  good  for  the  same  gryefe.  Item  a  dosen  figges, 
sodden  &  stamped  with  a  Iytle  goosegrece,  is  good.  Earth  wormes  sodden 
in  oyle,  hath  the  same  effecte. 

Item  the  skinne  of  a  mouse  clapped  al  hote  upon  ye  kibe:  with  the 
heare  outwarde,  and  it  shoulde  not  be  removed  durynge  .iii.  dayes. 


i94  PEDIATRICS  OF  THE  PAST 

A  PLAYSTER  FOR  A  KYBED  HEELE 

Take  newe  butter,  oyle  of  roses,  hennes  grece,  of  ech,  an  ouce,  put 
the  butter  and  the  grece  in  a  bygge  rape  rote,  or  in  Iacke  of  it,  in  a  greate 
apple,  or  onion,  &  whan  it  is  rosted  softe,  braye  it  the  with  oyle,  &  Iaye 
it  playsterwyse  upon  the  kybe. 

AN  OTHER 

Take  the  meate  of  apples  and  rapes  rosted  on  the  coles,  of  eche  .iii 
ounces,  freshe  butter  .ii.  ounces,  duckes  grese  or  swannes  grece,  an  ounce, 
stampe  the  all  in  a  morter  of  Ieade  yf  it  maye  be  had,  or  els  grynde  them 
on  a  fay  re  marble,  and  use  it. 

OF   CONSUMPCION  OF  LEANESSE 

Whan  a  child  cosumeth  or  waxeth  Ieane  withoute  anye  cause 
apparaunt,  ther  is  a  bathe  cSmended  of  authours,  to  wasshe  ye  childe  many 
times,  &  is  made  thus.  Take  the  head  and  feete  of  a  wether,  seeth  the  til 
the  bones  fal  a  sunder,  use  to  bath  ye  child  in  this  Iicour,  and  after 
annointe  hym  wyth  thys  ointmente  folowing.  Take  butter  without  salt, 
oile  of  roses  and  of  violettes,  of  eche  .i.  ounce,  the  fat  of  rawe  porke,  halfe 
an  ounce,  waxe,  a  quarteron  of  an  ounce,  make  an  ointmet,  wherwith  the 
child  must  be  rubbed  every  daye  twyse,  this  with  good  fedinge  shall 
encrease  his  strength  by  the  grace  of  God. 

OF  GOGLE  EYES 

This  impedimet  is  never  healed  but  in  a  very  yong  child,  even  at  the 
beginning,  wherunto  there  is  appointed  no  manner  kind  of  medicine,  but 
only  an  order  of  kepyng,  that  is  to  saye,  to  Iaye  the  chylde  so  in  his 
cradelle,  that  he  maye  beholde  directe  agaynste  the  light,  &  not  to  turne 
his  eies  on  either  of  bothe  sydes.  If  yet  he  beginne  to  gogle,  than  set  the 
cradell  after  suche  a  fourme,  that  the  light  maye  be  on  the  contrary 
side:  that  is,  on  the  same  syde  fro  whence  he  turneth  his  eies,  so  that  for 
desyre  of  light  he  may  dyrect  them  to  the  same  part,  &  so  by  custome, 
bring  them  to  ye  due  fashion,  and  in  the  night  there  ought  to  be  a  candel 
set  in  Iykewyse  to  cause  him  to  behold  upon  it,  &  remove  his  eies  from  ye 
evil  custome.  Also  grene  clothes,  yelowe,  or  purple,  are  very  good  in  this 
case  to  be  set,  as  is  said  afore.  Furthermore  a  coyfe  orabigge  stondingout 
besides  his  eies,  to  constraine  the  sight  to  beholde  directe  forwarde. 

OF  LYCE 

Sometimes  not  only  chyldre  but  also  other  ages,  are  annoyed  with 
Iyce,  they  procede  of  corrupt  humour,  and  are  engendred  within  ye 
skynne,  creplg  out  alyve  thorough  the  poores,  which  yf  they  beginne  to 


THOMAS  PHAER  195 

swarme  in  exceding  numbre,  that  disease  is  called  of  the  grekes 
Phthiryasys  whereof  Herode  dyed,  as  is  writte  in  the  actes  of  apostles: 
&  among  the  Romaines  Scilla,  which  was  a  great  tyraunt,  and  many  other 
have  ben  eaten  of  lice  to  deathe,  whiche  thing,  wha  it  happeneth  of  the 
plage  of  god,  is  is  past  remedy,  but  yf  it  procedeth  of  a  natural  cause,  ye 
may  wel  cure  it  by  the  meanes  folowynge.  Fyrste  let  the  paciente 
abstayne  from  all  kynde  of  corrupt  meates,  or  ye  brede  fleume, 
and  among  other,  fygges  and  dates  must  in  this  case  be  utterly  abhorred. 
Tha  make  a  lavatory  to  washe  and  scoure  the  body  twise  a  day,  thus. 
Take  water  of  the  sea,  or  els  bryne,  &  strong  lye  of  asshes,  of  eche  a  Iyke 
porcion,  wormwood  a  handfull,  seth  them  a  whyle,  and  after  wasshe  the 
bodye  with  the  same  Iicour. 

A  GOODLY  MEDICINE  FOR  TO  KYL  LYCE 

Take  the  groudes  or  dregges  of  oyle,  aloes,  wormwood,  &  the  gal  of  a 
bull,  or  of  an  oxe,  make  an  ointment  which  is  singuler  good  for  the  same 
purpose. 

AN  OTHER 

Take  musterde,  and  dissolve  it  in  vinegre,  with  a  Iitle  salte  peter,  and 
annoynt  the  places,  where  as  the  lice  are  wont  to  breed. 

Item  an  herbe  at  the  pothecaries  called  stamsacre,  brimstone,  and 
vinegre,  is  excedyng  good. 

It  is  good  to  give  the  pacient  often  in  his  drinke,  pouder  of  an  hartes 
home  brente. 

Stamsacre  with  oile  is  a  marvellouse  holsome  thyng  in  thys  case. 

AN  EXPERTE  MEDICINE  TO  DRYVE  AWAY  LYCE 

Take  the  groudes  or  dregges  of  oile,  or  in  Iacke  of  it,  fresh  swines 
grece,  a  sufficiet  quetitie,  wherin  ye  shal  chaie  an  ouce  of  quick- 
silver til  it  be  alsoken  into  the  grece,  than  take  pouder  of  stamsacre 
sersed,  and  myngle  al  togither,  make  a  gyrdyll  of  a  wollen  list  meete  for 
the  middle  of  ye  pacient,  &  al  to  annoynte  it  over  with  the  said  medicine, 
than  let  him  were  it  contynually  next  his  skinne,  for  it  is  a  singuler 
remedy  to  chase  awaye  the  vermyn.  The  only  odour  of  quycksilver  killeth 
Iyce. 

These  shall  be  suffycient  to  declare  at  this  time  in  this  Iitle  treatise 
of  the  cure  of  children,  which  yf  I  may  know  to  be  thankefully  received, 
I  will  by  gods  grace,  supplye  more  hereafter:  neyther  desyre  I  any  Ienger 
to  live,  than  I  will  employ  my  studyes  to  the  honour  of  god,  and  profit 
of  the  weale  publike. 

Thus  endeth  ye  boke  of  childerne,  composed  by 
Thomas  Phayer,  studiouse  in  Philosophic  and  Phisicke. 


FELIX  WURTZ 

[1518-1574  or  76] 

FELIX  WURTZ  was  a  remarkable  man;  his  influence  was 
great.  He  helped  to  change  the  course  of  surgical  procedure. 
True  enough,  Ambroise  Pare  overshadowed  him  in  his  own 
field,  so  that  it  is  hard  to  separate  the  influence  of  the  two.  One 
hears  so  much  more  of  Pare;  he  is  so  much  better  known.  But  the 
friend  of  Conrad  Gesner,  the  German  Pliny,  and  of  Paracelsus,  in 
his  own  day  and  for  a  century  later,  was  by  no  means  a  forgotten 
man.  He  wrote  a  book  that  went  through  some  fourteen  to  sixteen 
editions  within  a  century,  no  mean  feat  in  these  days  of  cheap 
printing.  In  the  sixteenth  century,  when  the  printing  press  was 
in  its  infancy,  the  achievement  was  marvelous  and  can  mean  only 
one  thing.  He  had  a  message  and  one  that  was  worth  while. 

Wurtz  was  the  son  of  a  surgeon  who  practiced  in  Basel. 
Born  in  15 14,  the  young  Felix  was  sent  to  Nuremberg  to  study, 
but  returned  to  follow  in  his  father's  footsteps.  In  Basel,  he  lived, 
worked  and,  in  1574  or  1576,  died.  His  son,  Rudolph,  is  credited 
by  Baas  with  the  authorship  of  the  little  book  on  children,  but 
on  what  authority  one  knows  not.  The  style  and  the  content  is 
old  Felix  over  and  over  again  and  even  if  young  Rudolph  did 
write  it,  the  inspiration  was  certainly  parental. 

The  book  on  surgery  was  entitled  "  Practica  der  Wundartzney, 
darin  allerlei  schadliche  Missbrauche  des  Wundarztes  abgeschafft 
wurden,  etc."  It  appeared  in  Basel  in  1563,  and  had  a  remarkable 
success.  In  addition  to  the  numerous  German  editions,  it  was 
translated  into  French  and  into  English. 

As  might  be  expected  of  an  intimate  of  Theophrastus  Bombast 
von  Hohenheim,  it  shows  a  freedom  from  prejudice  and  an  influ- 
ence beyond  that  of  the  said  Paracelsus  himself.  It  is  a  charming 
classic,  free,  easy  and  chatty  in  its  style.  With  the  abuses  of 
the  day,  Wiirtz  had  scant  sympathy,  nor  does  he  spare  his  words 
when  he  sweepingly  condemns  them.  He  descants  on  the  futility, 
nay  the  harm,  of  such  practices  as  the  cautery  for  hemorrhage,  or 

196 


FELIX  WURTZ  197 

probing  wounds  and  stitching  them  together.  The  prevalent 
custom  of  packing  wounds  with  Quellmissel,  as  the  filthy  rags  and 
clouts  were  called,  and  the  salves,  oils  and  balsams  were  decried. 

He  used  splints  in  the  treatment  of  fractures.  He  knew  his 
subject  clinically  and,  living  in  a  century  which  has  been  called 
that  of  thoughtful  reflection  (it  was  all  of  that),  he  knew  pyemia, 
wound  diphtheria,  traumatic  fever  and  healing  by  first  intention. 
He  knew  so  much  more  than  his  mere  surgery !  The  value  of  the 
diet  in  the  wounded,  he  graphically  puts:  "Hold  him  as  a  woman  in 
childbed."  He  knew  and  preached  the  value  of  anatomical  knowl- 
edge for  surgeons.  This  sounds  strange  in  our  ears,  but  his,  and 
the  subsequent,  ages  were  treated  by  surgeons  who  were  not  unlike 
the  honest  old  Scotsman  who  exclaimed,  "Oh  damn  your  anatomy, 
stick  close  to  the  bone!" 

Wiirtz  was  a  modern:  "A  surgeon  should  know  the  structure  of 
the  skeleton,  the  muscles,  and  the  chief  nerves  and  vessels,  so 
that  when  he  looks  at  a  wound  he  may  at  once  recognize  what 
organs  are  wounded  and  not  need  to  rake  and  poke  with  a  probe." 
The  little  book  on  children  needs  little  comment.  The  clear 
style,  the  lack  of  uncertainty  of  statement,  the  little  personal 
glimpses,  make  it  worth  while.  It  is  the  first  book  after  Hippo- 
crates to  treat  of  infantile  orthopedics. 

The  English  was  done  by  Abraham  Lenertzon  Fox,  a  surgeon 
at  Zaerdam,  from  the  second  translation  into  Low  Dutch,  from 
the  twenty-eighth  copy  printed  in  the  German  tongue.  This  is 
appended  to  the  treatise  on  experimental  surgery  in  four  parts, 
and  contains  a  very  considerable  amount  of  good  common  sense  and 
observation  mixed  up  with  considerable  praise  to  God  and  the 
prevailing  ideas  of  the  time.  He  outlines  the  care  of  children, 
how  to  bathe  them,  what  to  do  for  cramps;  he  notes  the  fact  that 
children  are  hurt  if  after  bathing  they  are  laid  behind  a  hot  oven; 
of  the  thrush,  and  blisters  on  the  cheek  or  tongue,  what  to  do  if 
they  feel  an  itch  in  their  hands  or  feet,  how  to  set  and  dress 
cracked  joints,  on  the  clothing  and  so  on.  It  is  a  short  little  book 
which  is  reprinted  here  in  its  entirety.  It  may  be  opened  at  any 
place  and  read  with  pleasure. 


An  Experimental  Treatise  of 

SURGERIE, 

In  Four  Parts. 


i .    The  firft  Part  (hewing  the  dangerous  Abufcs  committed 

among  the  Modern  Surgeons. 

2.  Of  Cures  of  all  forts  of  Wounds  In  Mans  Body>  from  the  Held  to  the  Toe,  and 
of  other  Infirmities  belonging  to  Surgerlcj  how  the  fame  ought  to  be  obferved  ac- 
cording to  the  Fundamentals  cf  Art,  to  be  handled  and  cured. 

3.  CM 'he  Symptomes  of  Wounds,  how  they  are  to  be  difcerned  and  known  before 
they  appear,  what  they  foretell,  how  to  prevent  them,  and  how  to  cure  them  when 
apparent,   oYc. 

4.  Treating  of  all  kinds  of  Balmes,  Salves,  Plaiftcrs,  Ointments,  Oyles,  Blood- 
flenchers,  Potioni,  Tents,  Corrofives,  &c.  which  are  ufed  foe  Wounds,  and 
hivrbeen  mentioned  hitherto  in  the  former  Pans  of  this  Book}  how  they  are  to  be 
Artificiilly  prepared,  and  ufed  well.  All  which  arc  very  plain,  and  eafic  to  be  un- 
der flood  and  managed ,  by  an  ordinary  capacity. 

By  that  mod  famous  and  renowned  Surgeon, 
Fblix  Wurtz,  Citie  Surgeon  at  Bafell.  Thepraifeof 
whofe  worth  you  may  read  in  the  following  Epiftles,  the  worth 
it  felf  in  this  Book. 

Exadly  perufed  after  the  Authors  own  Manufcrip,  by  Rodolph  Wnrtz.% 
Surgeon  at  Stroikhrg. 

Faithfutlv  the  fecond  time  Tranftared  into  Nedther  Butch,  out  of 
the  twenty  eighth  Copy  printed  in  the  Gcrmw  Ton&ut ,  and  nowalfoEi/g/r/?Wand 
much  corrected,  by  Abraham  Lenektzon   Fox,  Surgeon  at  ZacrJart.0 

Whereunto «  added  a  very  nrceffary  and  ufeful  Piece,  by  the.  fame 
Author,  callcdthe  Children  Book,  Treating  of  all  things  which  are  necifia- 
iytoheknownbyallthofe,  to  whofc  trull  and  ovcrlooking,little  Children  are  com- 
mitted. 


Lwdw*  Printed  by  Gartruie  Vawfon,  over  again  ft  the  B/uct  Horfc  In  Aldcrj&itL 
Stmt,  and  ajcto  be  fold  at  the  Book-  fillers  Shops.    165$. 


Title  page  of  the  English  translation  of  Felix  Wurtz'  "Treatise  of  Surgerie"  which 

contains  his  "Children's  Book." 


FELIX  WURTZ  199 

THE  CHILDREN'S  BOOK 

of 

FELIX  WURTZ, 

A  famous  and  expert  Surgeon. 

This  Book  was  never  published  till  now. 

Treating  of  infirmities  and  defects  of  new  born  Children;  and  of  the 

faults  and  abuses,  which  wet  or  dry  Nurses  commit  among  and 

against  little  Children;  and  of  medicins  and  Cures,  of  such 

Children  which  receaved  hurt  in  that  way. 

Written  for  young  Surgeons,  wet  and  dry  Nurses,  Maid  Servants,  and 
other  parties,  to  whose  trust  and  overlooking  little  Children  are 

committed.1 


My  purpose  is  to  communicate  an  usual  little  Treatise  concerning 
the  infirmities  of  new  born  Babes  and  sucking  Children,  which  are 
befallen  them  by  the  neglect  of  wet  and  dry  Nurses,  or  else  brought  them 
into  the  world  from  their  mothers  wombe.  In  the  first  place  I  will  speak 
something  how  Midwives,  wet  and  dry  Nurses  ought  to  be  conditioned, 
that  they  may  the  better  deal  with  such  little  Children  or  Babes,  even 
as  it  becomes  an  understanding,  sober,  godly  Woman. 

Such  Women  to  whose  trust  little  Babes  are  committed,  ought  to 
be  pious,  honest,  modest,  and  civil  in  words,  works  and  manners:  she 
must  be  one,  that  hath  been  a  Mother  of  Children,  and  is  expert  in 
those  waies;  for  experience  is  the  Mistress  of  things,  and  there  is  more 
credit  to  be  given  to  experienced  Women,  than  to  such  which  know 
things  by  hearsay.  Therefore  if  a  Midwife  be  a  Woman  of  credit  and 
fidelitie,  and  hath  endured  in  her  own  body,  anguish,  miseries,  and 
pains,  which  others  neither  can  nor  will  beleeve,  because  they  never 
endured  any  torments  in  their  own  bodyes;  neither  may  they  hear  nor 
have  heard  of  the  like :  those  that  had  such  things  befallen  them,  know 
what  they  are :  neither  is  there  any  need  to  tell  unto  such,  what  miseries 
pains  and  torments  mean:  and  those  that  were  never  in  such  perilous 

1  At  the  outset  we  are  struck  with  the  sagacity  of  the  author.  When  one  in  this 
era,  which  Payne  has  designated  "the  age  of  the  child/*  considers  the  amount  of 
disease  and  death  due  to  preventable  causes,  to  the  ignorance  or  wilful  ignorance  of 
those  who  have  to  do  with  children,  we  realize  how  forcibly  this  must  have  struck  old 
Felix  Wiirtz  in  his  age  when  it  impelled  him  to  use  it  on  his  title  page.  A  wise  man  and 
one  whom  we  may  follow. 


&fJfa*TWfW™1Tl 


The  CMclrens  J^ook 

OF 

FELIX  WV%TZ% 

A  famous  and  expert  Surgeon- 

This  Book  was  never  publifhed  till  now. 

Treating  of  infirmities  and  defe&s  of  new 

born  Children  •,  and  of  the  faults  and  abufes, 

which  wet  or  dry  Nurfes  commit  among  and 

againft  little  Children;  and  of  Medicins 

and  Cures,  of  fuch  Children  which  re- 

ceaved  hurt  in  that  way. 

Written  for  young  Surgeons,  wet  and  dry  Nurfes, 

Maid  Servants,  and  other  parties,  to  whofc  truft  and 

overlooking  little  Children  are  committed. 

f  Y  purpofe  is  to  communicate  an  ufual  little  Trea- 
tife  concerning  the  infirmities  of  new  born 
Babes  and  fucking  Children,  which  are  befal- 
len them  by  the  negleft  of  wet  and  dry  Nurfes 
or  elfe  brought  them  into  the  world  from  their  mothers 
wombe.    In  the  fixft  place  I  will  fpeak  fometbing  how  Mid. 


X  x  a 


wives 


First  page  of  Felix  Wiirtz*  'The  Children's  Book.' 


FELIX  WURTZ 


201 


cases,    may   hold   their   tongues    and    not   speak   of   it    jeeringly  or 
contemptibly.2 

It  falls  out  often,  that  in  such  dangerous  travails,  one,  three,  or  two 
loose  their  lives,  besides  the  loss  a  good  Husband  hath  in  his  Wife,  and 
poor  Children  in  their  Mother,  &c.  And  in  case  such  parties  may  escape 
with  their  lives  in  hard  travails,  yet  are  they  so  pulled  and  torn,  that 
they  are  made  unfit  for  any  work,  which  otherwise  might  have 
better  been  preferred,  if  honestly  and  faithfully  they  had  been  dealt 
withal.  This  I  speak  not  as  an  invective  against  others;  let  every  one 
look  to  it,  what  they  are  instrusted  withal,  and  make  a  conscience  in 
their  waies,  remembering  also  that  they  must  be  accountable  unto  God 
for  it,  then  they  need  not  to  be  put  in  mind  of  it  by  my  words. 

I  beseech  every  pious  Matron,  not  to  take  ill  the  things  I  speak  of; 
for  what  I  intend  here  is  for  the  good  of  little  children,  which  cannot 
complain  of  their  griefs  but  by  crying.3 

For  it  is  most  certain,  that  Children  will  not  cry,  unless  they  ail 
somewhat;  because  it  is  more  ease  for  them  when  quiet:  and  they  are  not  re°eai?hei 
able  to  make  their  complaints  any  other  way  but  by  crying.  Hence  we  griefs- 
are  to  note,  that  as  soon  as  man  is  born  into  the  world,  then  is  he  made 
subject  to  endure  pains.  Therefore  good  notice  must  be  taken  what  these 
crying  children  aileth,  wherein  they  are  grieved  or  pained,  that  with  one 
thing  or  other  they  may  be  holp.  I  do  not  write  here  of  such,  that  are 
yet  under  birth,  but  of  those  that  are  brought  already  into  the  world. 
For  I  presume  not  to  write  of  such  things  which  I  never  had  any  experi- 
ence of;  those  I  leave  unto  wiser  men.  Things  that  are  not  commonly 
known,  I  intend  to  describe  for  the  good  of  bearing  Women :  for  I  have 
been  much  sent  for  to  come  to  Children,  and  experimentally,  knew 
this  or  that  defect  in  them;  and  parents  themselves  confessed,  that  it 
stood  with  their  Children  as  I  told  them :  and  gave  warning  afterward  to 
young  and  old,  to  look  to  it  if  the  like  cases  befall  their  Children.  By 
some  my  faithful  counsell  was  slighted,  not  hearkening  after,  much  less 
to  follow  my  advice;  however  some  honest  Women  thankfully  accepted 
of  my  counsell. 

2  Our  author  gives  an  admirable  description  of  the  requisites  of  a  nurse,  although 
one  cannot  agree  with  him  regarding  maternity  as  a  requisite  in  the  training  of  the 
woman  who  is  to  care  for  infants,  any  more  than  paternity  should  be  included  in  the 
curriculum  of  the  pediatrist;  though,  in  his  day,  the  wife  and  mother  was  doubtless 
more  important  in  the  care  of  the  young  than  in  this  age  of  comparative  sterility  in 
which  some  bring  children  into  the  world  while  others  care  for  them. 

3  The  importance  of  understanding  when  infants  are  ill  is  made  apparent.  One 
often  hears  the  banal  remark  that  it  must  be  difficult  to  treat  children  when  they 
cannot  tell  their  troubles,  to  which  one  may  safely  make  reply  that  the  matter  is 
evenly  balanced,  for  if  they  cannot  tell  what  hurts  them  neither  do  they  lie  about 
their  condition.  The  baby  is  the  only  honest  human  being;  if  he  is  happy  he  shows  it; 
if  he  is  unhappy  or  in  pain  there  is  no  doubt  of  it. 


202 


PEDIATRICS  OF  THE  PAST 


He  hath  seen 
the  defects  of 
manyChildren, 
calls  to  God  to 
assist  him  in 
the  writing 
thereof. 


How  a  Nurse 
to  a  green 
Woman  must 
be  fitted. 


Children  must 
be  handled 

tenderly. 


Soft  fingers 
commonlous- 


A  tender  Child 
must  not  be 
handled  rudely. 


Having  seen  several  pains  and  defects  in  Children,  which  could  not 
make  their  griefs  known  but  with  crying,  therefore  I  call  to  God  Almighty 
for  his  Grace,  that  he  would  be  pleased  to  assist  me  in  this  my  present 
writing,  that  it  may  tend  to  the  praise,  Honour,  and  Glory  of  His  Name; 
to  the  welfare  of  young  Children,  and  to  the  good  of  this  which  love 
Children:  Amen. 

I  do  not  write  here  for  those,  which  know  things  as  well  or  better  than 
I;  neither  do  I  carp  at  any:  but  in  case  there  be  any  which  do  not  under- 
stand these  waies,  neither  had  any  Children,  neither  considered  what 
such  pains  and  defects  incident  to  Children,  might  prove;  to  such  I 
dedicate  this  my  Treatise,  for  an  instruction  unto  them. 

To  return  again  to  Nurses,  they  must  be  of  an  honest  godly  life, 
neither  must  they  drudge  in  heavy  toyling  works,  neither  in  the  field  or 
garden,  neither  within  doors  with  washing,  scouring;  nor  about  the  fire, 
or  handle  any  other  rough  works,  whereby  their  hands  are  made  hard 
and  rough.  In  case  that  such  Midwives  or  Nurses  are  driven  to  do  such 
rustick  works,  it  behoveth  a  Magistrate  or  Congregation,  to  allow  a 
certain  annuity  to  them,  that  they  be  not  forced  to  fall  to  such  rough 
and  hard  works.  To  clear  this  with  a  comparison :  if  the  hands  are  kept 
clean,  because  their  work  in  hand  is  about  Silk,  fine  Linnen,  Laces  of 
Gold  or  Silver,  is  Man  not  more  precious  and  worthier  to  be  kept  clean 
than  all  these?  especially  when  that  young  tender  Children  are  not 
able  to  speak  or  complain  against  those,  which  deal  roughly  with  them, 
more  than  their  nature  and  body  is  able  to  brook  withall,  by  hard 
pressing,  thrusting,  pinching,  burning,  &c.  and  thus  such  unhappy 
girds,  Children  are  put  unto. 

I  have  seen  both  Mothers  and  Nurses,  to  bind  and  tye  their  children 
so  hard,  which  for  pitty  sake  made  me  weep.  A  Woman  that  usually 
handleth  neat  work,  whose  hands  are  pure,  what  advantage  hath  she 
before  such  a  one,  which  is  forced  to  do  all  manner  of  skullion  work? 
to  feel  with  her  fingers  ends,  &c.  As  a  Barber  knoweth  the  commodious- 
ness  of  soft  fingers  at  the  touching  of  veins,  before  him,  whose  finger  ends 
are  rough  and  hard :  and  those'  also  know  it,  which  work  in  silk. 

A  Vein  broken  Child  is  like  to  flesh  wrapped  in  a  naked  skin,  as  every 
one  may  observe  also,  who  had  a  swelling  or  wound  on  his  body  which  is 
but  newly  healed,  how  tender  and  soft  that  new  skin  feeleth:  even  so 
is  it  with  a  new  born  Child.  If  a  man  doth  but  scratch  his  finger,  or  is 
pinched,  if  a  heat  comes  to  it,  how  soon  he  complaineth  of  it;  or  if  he  be 
hurt  any  other  way  by  a  fall,  thrust,  &c.  whereby  some  danger  he  falls 
into,  and  that  place  is  more  painfull  unto  him  than  others,  which  are  not 
hurt.  These  things  any  one  may  be  sensible  of;  much  more  will  be  new 
born  Babes,  if  roughly  or  rudely  handled,  or  are  hurt  in  the  least  manner 
either  with  hard  hands,  rough  woolen  clothes:  or  course  unblanched 


FELIX  WURTZ 


203 


Iinnen,  or  hot  and  hard  swaddlfngs;  or  when  laid  upon  hard  and  pricking 
straw,  feather,  or  dryed  oak  leaves ;  laying  the  Child  in  a  Cradle  purposely 
made,  whereby  the  Childs  head  may  be  framed  round,  lying  it  on  the 
back  also,  that  thus  out-stretched  it  may  look  upward,  which  furthereth 
Children's  fancie  unto  melancholly,  itch,  frights,  and  the  like:  for 
Children  are  sooner  full  of  frights,  if  placed  with  their  heads  upright, 
than  if  laid  a  little  side  way,  and  that  their  pillowes  may  not  yield  so 
soon  or  so  much  to  their  head,  as  to  fall  deep  in,  neither  must  the  Nurses 
make  it  so  purposely,  as  to  lay  the  Child  hollow  in  the  pillow  that  the 
Children  may  the  easier  turn  or  slide:  this  kind  of  lying  hurteth  the 
Childs  memory  very  much,  or  it  causeth  other  simptoms,  which  after- 
ward are  not  reduced  so  easily,  and  the  Children  being  laid  on  their 
backs,  it  causeth  heavy  and  melancholly  dreames,  which  old  people  do 
find,  if  they  lie  on  their  backs,  and  the  heavy  melancholly  blood  runs 
about  their  heart,  putting  them  into  anguishes  and  frights:  some  do 
think  that  then  they  are  awakened,  are  troubled  with  strange  thoughts, 
break  forth  into  strange  words,  from  their  fancies  they  had  in  their  sleep; 
he  thinketh  he  awakneth,  &  yet  cannot  awaken,  because  his  talking  and 
out-calling  keeps  him  thus. 

Some  use  to  lie  their  Children  in  the  Cradles  higher  at  their  feet, 
than  at  their  head  or  heart,  at  which  I  marvailed  many  times.  But  if 
a  Child  hath  scabbed  swelled  Ieggs  or  feet,  then  their  feet  must  be  laid 
somewhat  higher,  that  the  blood  run  not  too  much  into  the  feet,  and  the 
pulling  itching  pains  be  not  increased  thereby:  let  every  one  be  judge 
here,  that  is  troubled  with  naughty  Ieggs,  if  he  hath  but  a  little  blister 
about  his  foot  or  ancle,  what  pains  he  feeleth  then,  if  his  Iegg  hangeth 
down :  what  do  you  think  a  Child  endureth  in  this  case. i 

If  the  Child  be  sound  in  body,  Ieggs  and  feet,  then  it  may  lie  higher 
at  his  feet  than  at  his  sides,  but  not  higher  than  it  Iyeth  at  his  heart  and 
head:  this  I  hold  to  be  very  good.  Therefore  my  advice  is,  to  make  that 
part  of  the  bed  somewhat  higher  where  the  child's  side  is  to  lye,  then 
his  head  and  heart  will  lye  higher  than  his  feet  and  body,  which  is  the 
safest  and  easiest  way  for  his  rest. 

Touching  the  rocking  of  Children ;  some  Mothers  use  their  Children 
to  it  at  the  first,  but  others  do  it  when  they  would  have  them  sleep,  and 
others  rock  them  when  they  cry;  others  there  are  which  will  not  use  their 
Children  to  it  at  all,  as  one  a  Clergy  Mans  Wife  did,  who  set  her  Child 
every  night  into  a  Cellar,  because  nothing  should  disquiet  him  in  his 
sleep,  not  thinking  on  any  other  things  the  Child  might  befall,  but  no 


Lyeing  on  the 
back  is 
hurtfulL 


Children  must 
be  higher  at 
their  feet  than 
their  head 
when? 


To  lay  a  sound 
child  that  it 
may  sleep  well. 


What  the  rock- 
ing of  the 
Cradle  is? 


4  This  use  of  a  cradle  higher  at  the  foot  is  of  particular  interest  with  regard  to  the 
now  prevalent  therapeutic  custom  of  treating  many  conditions,  chiefly  of  adults,  in 
this  fashion.  Wiirtz  lays  down  some  sensible  rules  governing  posture  in  infantile 
diseases. 


204  PEDIATRICS  OF  THE  PAST 

honest  Woman  I  hope  will  imitate  that  fashion.  In  my  judgement  I 
hold  it  to  be  best,  that  if  a  Child  be  laid  down  in  God's  Name,  &c.  to 
rock  it  gently,  and  not  too  hard,  then  let  it  rest.  But  if  a  Child  sleepeth 
unquietly  being  as  it  were  frighted,  as  it  can  be  perceaved,  when  it 
snorteth,  snuff eth,  or  when  frightned,  or  cryeth,  then  rock  it  gently  again, 
then  the  melancholly  blood  which  opprest  the  Child,  and  frightned  it, 
is  by  rocking  brought  to  right  again  out  of  its  fear  and  anguish,  and  are 
dispersed  or  expelled. 

It  falls  out  sometimes,  that  a  Mother  meaneth  to  quiet  her  Child  with 
rocking,  whereby  the  Child  is  the  more  unquieter,  and  with  crying 
inflamed  his  head  so  vehemently,  that  in  many  daies  he  cannot  be 
brought  to  right  again:  sometimes  such  a  Child  aileth  that  which  a 
Mother  doth  not  think  of,  supposing  to  be  the  Childs  frowardness, 
which  is  not  so,  but  it  feeleth  something  to  be  amiss  in  the  bed,  which 
doth  hurt  it,  or  its  hand  Iyeth  hard,  or  a  prick,  straw,  or  hard  feather 
doth  prick  it,  or  a  pin,  which  careless  Nurses  left  in  the  Iinnen,  or  a 
flea  or  louse  tormenteth  the  Child :  therefore  my  advice  is,  that  if  a 
Child  will  not  be  quieted,  to  take  it  up  and  see  what  doth  ail  it.5 
To  help  Child-  Little  Children  are  tormented  also  sometimes  with  the  Cramp,  when 
Cramp.  they  are  taken  up,  then  their  blood  runs  up  and  down,  and  by  that 

means  are  they  quieted;  few  people  take  notice  of  the  cause  of  it;  and  is 
remedied  when  the  blood  getteth  its  course  again,  and  come  to  that 
place  which  was  bereaved  of  it,  it  warmeth  that  part  again,  which 
warmth  driveth  the  Cramp  away,  and  the  pains  which  are  caused 
thereby.  A  Cramp  will  hold  a  Child  strongly  if  once  it  takes  possession 
in  a  Child,  causeth  great  pains  below  and  above;  and  these  pains  are 
to  the  Children  continue  in  their  crying,  and  commonly  the  Gout  doth 
accompany  it.  Therefore  these  things  must  be  taken  good  notice  of, 
when  the  Child  cryeth  much  either  half  sleeping  or  awakened,  then 
take  it  up,  and  wrap  it  in  warm  clothes.  This  misery  is  caused  by  the 
following  things,  viz,  when  Children  are  kept  cold  in  the  Nurses  or 
Mothers  lap,  or  in  the  bed,  bath,  or  lye  in  wet  clouts,  bepissed  by 
Children,  or  such  Children  sit  naked  on  the  flower,  or  stone,  I  have  seen 
that  the  sitting  so  naked  on  cold  places  hath  proved  sq^dangerous  unto 
Children,  that  in  short  time  they  were  creepled,  with  whom  I  had  great 
toyle,  before  I  could  recover  them  to  their  former  health;  for  if  once 
they  take  cold  in  that  way,  they  are  hardly  recovered  again. 

This  befalls  old  people  also,  some  whereof  I  have  seen  dye  of,  in  great 
anguish  and  misery,  and  lay  long  by  it  before  they  dyed.  Therefore 
6  A  very  sensible  bit  of  advice  and  one  often  not  heeded  in  the  present  day.  One 
sees,  not  infrequently,  some  minor  discomfort  producing  such  severe  symptoms  that 
the  parents  or  nurse  think  the  child  extremely  ill  when  a  suitable  examination  would 
have  revealed  the  trouble.  Anent  the  rocking  of  infants  to  sleep,  one  need  scarcely 
comment,  a  rocking  crib  in  these  days  is  a  curiosity  in  this  country 


FELIX  WURTZ 


205 


tender  Children  must  by  all  means  be  kept  warm,  not  to  shake  stir  and 
dally  them  too  much.  If  a  new  skin  in  old  people  be  tender,  what  is  it 
you  think  in  a  new  born  Babe?  Doth  a  small  thing  pain  you  so  much  on  a 
finger,  how  painfull  is  it  then  to  a  Child,  which  is  tormented  all  the 
body  over,  which  hath  but  a  tender  new  grown  flesh?  if  such  a  perfect 
Child  is  tormented  so  soon,  what  shall  we  think  of  a  Child,  which 
stayed  not  in  the  wombe  its  full  time?  surely  it  is  twice  worse  with  him. 

Touching  Baths  of  Children,  it  is  known  that  they  are  bathed  some- 
times so  hot,  that  the  heat  thereof  is  scarcely  sufferable  to  an  old  bodies 
hand,  whose  skin  is  strong:  we  must  note  here,  that  if  a  water  bath  be 
made  for  any  one,  which  seemeth  to  him  to  be  not  very  hot,  at  that 
time  when  he  was  scabby,  and  went  in  the  first  time;  so  the  skin  of  a 
Child  is  so  thin  and  tender,  as  his,  who  is  full  of  scabs.  A  hand  which  is 
usually  naked,  can  endure  more  cold,  heat,  air,  &c.  than  that  strong 
sound  body,  which  usually  is  not  naked,  &c.  This  every  one  doth 
or  may  conceive  easily  if  he  taken  notice  of:  some  Women  are  so 
careless,  that  they  take  no  notice,  nor  observe,  what  pains  they  do  or 
may  cause  unto  others,  and  make  Baths  for  Children  so  hot,  as  if  Children 
were  able  to  brook  with,  not  considering,  that  Children  are  weak  in 
their  little  bodies,  and  not  so  strong,  as  aged  people  are  in  theirs. 

The  bodies  of  such  little  Children  may  be  compared  to  a  young  and 
tender  root  or  twigg  of  a  Tree,  which  in  the  souch  is  not  so  grosse  as  an 
old  root  or  branch  of  a  Tree;  take  heed  you  cause  no  paines  unto  little 
Children,  that  they  may  not  be  filled  with  pains  in  their  joints,  whereby 
they  are  made  unfit  ever  to  follow  closely  or  well  any  mechanick  calling. 
And  it  is  a  most  certain  thing,  that  those  which  are  bathed  too  hot,  get 
a  more  tany  skin,  than  those  which  are  not  bathed  so  hot:  neither 
must  they  be  bathed  too  cold,  else  there  will  be  caused  to  them  pains 
in  the  belly,  and  the  cramp,  and  is  then  most  of  all  caused,  when  Children 
are  naked  in  the  water,  are  not  covered  in  their  body,  or  else  when  the 
bath  is  made  too  thin,  or  when  such  a  bath  is  made  but  once,  and  no 
more  used  a  long  time  after,  and  no  order  is  observed  herein,  or  when 
the  Child  is  taken  out  of  the  bath,  and  they  care  not  how  long  they  keep 
it  in  the  lap.  Some  use  to  lye  the  Children  bathed  behind  the  hot  oven, 
whereby  the  Child  may  soon  be  stiffled  or  choaked,  not  regarding, 
whether  that  heat  doth  not  cause  a  pain  in  the  body  or  head,  supposing 
onely  if  the  Child  be  but  laid  behind  the  oven,  then  is  it  well  cared  for. 
Some  have  that  custome,  when  they  have  bathed  their  children,  then 
they  rub  them  with  Wine,  and  the  whites  of  Eggs,  saying  now  I  think 
I  washed  my  Child  neatly;  and  rub  it  so  strongly  as  if  they  had  an  old 
bodyes  skin  in  hand,  which  is  grown  hard,  thereby  to  soften  it;  they  do 
not  consider,  that  if  an  old  bodyes  skin  after  bath  should  be  so  rubbed, 
and  the  party  were  scabbed,  how  he  would  be  affected  with  it:  or  if  a 


Child's  Bath. 


Pains  in  the 
belly,  and  the 
Cramp  how 
caused. 


Children  are 
hurt  if  after 
bathing  are 
laid  behind  a 
hot  oven. ' 


206 


PEDIATRICS  OF  THE  PAST 


Children  must 
not  be  kept 
long  naked  or 
wet. 


A.  wet  head  tak- 
ing cold  wron-  i 
geth  young  and 
old  people. 


Of  Childrens 
thrush  in  the 
mouth. 


Cause  of  .the 
thrush. 


sound  bodyes  skin  should  be  thus  stretched  or  reacht,  what  pain  it  would 
cause  to  it,  little  do  they  consider,  what  great  wrongs  are  done  thereby 
unto  little  Children. 

All  honest  Mothers  and  Nurses  will  be  cautious  and  carefull  that  their 
Children  be  not  uncovered  too  long,  be  it  either  at  their  taking  up  or 
their  carrying  about,  and  ought  to  be  laid  dry  down  again;  in  like  manner 
when  they  are  taken  out  of  the  bath,  they  must  be  received  in  a  warm 
cloth,  the  Dray  also  in  which  the  Child  was  bathed,  must  be  so  placed, 
that  no  ayr  may  come  to  the  Child  in  the  bath,  and  that  it  take  no  cold 
by  opening  of  Casements,  Doors,  &c. 

The  child  must  be  well  guarded  above,  to  be  wet  the  less,  and  its 
head  dressings  and  attires  be  not  made  wet,  else  great  hurt  and  wrong 
is  done  unto  the  Child :  for  a  Childs  head  or  body  being  washed,  and  then 
to  let  it  sit  thus  wet,  and  let  it  take  cold,  it  wrongeth  the  Child  so 
much,  that  it  will  stick  unto  him  even  to  his  old  age,  rheums  will  trouble 
them,  about  the  eyes,  their  hearing  decayeth,  their  heads  break  out, 
especially  if  you  let  Children  take  cold  in  their  wet  heads,  then  such 
wrongs  are  done  unto  them,  which  hardly  can  be  expressed. 

In  case  a  Childs  head  must  be  washed  and  cleansed,  then  it  must  be 
dryed  again  suddainly,  let  it  not  be  moist  too  long,  for  if  you  do,  it  will 
be  troubled  with  running  eyes,  hard  hearing,  rheums  in  the  face,  nose, 
gumms,  shoulders,  arms,  and  their  body  will  be  troubled  with  cold 
diseases,  which  he  will  not  be  rid  of  all  his  lifetime.  Therefore  I  warn 
you  faithfully,  that  you  keep  not  long  Childrens  heads  wet,  nor  let  them 
come  into  the  cold  with  wet  heads,  which  is  more  dangerous  than  if  in 
a  warm  place. 

Now  will  I  speak  of  the  thrush  in  Children,  which  caused  many 
Children  starv'd,  and  I  cured  of  that  weakness,  more  than  a  hundred 
of  them. 

For  a  warning,  I  will  give  a  hint  of  the  faults  committed  by  Nurses, 
in  their  rude  manner  of  washing  Childrens  mouthes,  whereby  they  do  and 
have  caused  this  great  mischief  unto  Children. 

Some  indiscreet  people  take  wool,  or  rough  Iinnen,  or  the  bath  cloth 
out  of  the  bath,  feel  with  it  to  the  throat,  and  so  wash  it  saying  how  furr'd 
is  this  Child  in  the  throat,  I  must  wash  off  that  white  stuff,  and  rub  it  so 
hard  that  they  pull  off  their  subtile  skin,  even  as  a  soft  rind  is  peeled 
off  the  tree,  which  if  once  done,  then  the  next  day  his  mouth  groweth 
more  white,  which  if  they  see  it,  then  they  feel  further  into  the  mouth, 
and  fall  on  washing  of  his  mouth,  saying,  this  Childs  tongue  looks 
white,  I  must  scrape  his  tongue,  and  scrape  and  wash  away  the  tender 
skin  of  his  tongue,  and  make  it  bleed,  which  surely  causeth  the  thrush 
in  the  mouth,  and  the  more  they  go  on  in  their  washing,  the  worse  they 
make  it.  This  great  fault  about  the  mouth  washing,  hath  moved  me  to 


FELIX  WURTZ 


207 


write  this  Treatise,  and  I  intreat  all  good  people  not  to  make  use  of  such 
washing,  and  to  warn  others  from  it  also:  for  the  tongue  doth  cleanse 
itself,  being  a  member  which  is  still  in  motion,  and  groweth  not  weary.6 

It  may  be  objected,  why  should  not  Children  be  washed  in  their 
mouthes,  if  filled  up  with  slyme,  and  to  take  away  that  filth? 

I  answer,  this  reason  is  produced  onely  by  ignorant  people,  which 
neither  know,  nor  can  distinguish,  what  this  slyme,  slabber,  or  skin  is: 
what  wonder?  if  they  cannot  discern  it  in  aged  people,  how  should  they 
be  able  to  discern  it  in  Children,  in  whom  it  may  sooner  be  discerned 
than  in  aged  people,  and  is  a  great  deal  more  dangerous  in  aged  people, 
than  in  little  Babes. 

It  is  known  among  judicious  people,  that  every  new  born  Child, 
if  sound,  is  pale  and  white  in  the  throat,  and  if  it  be  red  or  green  in  the 
throat,  then  is  it  hurt  or  wounded,  and  his  cheeks  and  tongue  are  yet 
white,  especially  on  the  middlemost  streak,  what  need  then  to  have  it 
scraped,  washed  or  rubbed,  to  make  it  red? 

Sometimes  there  rise  blisters  on  the  tongue,  and  also  on  the  cheeks 
within,  and  at  the  throat;  of  these  I  do  not  speak  now,  but  if  a  Mother 
or  a  Nurse  knoweth  whether  they  are  blisters  or  no,  as  many  of  such  were 
brought  to  me,  which  were  tampered  too  long  withal,  insomuch  that 
their  mouthes  stunk,  and  could  neither  eat  nor  drink :  therefore  care  must 
be  had  to  be  sure  whether  it  be  the  beginning  of  a  thrush,  or  whether  it 
be  a  defect  the  Child  brought  into  the  world ;  for  if  their  mouthes  stink 
strongly,  then  is  it  not  natural,  but  comes  from  putrifaction  and  filth: 
for  such  I  do  not  say,  that  no  remedies  should  be  used;  but  I  speak  of 
those,  which  scrape  and  rub  Childrens  mouthes  so  long,  till  they  have 
pulled  off  that  little  skin,  whereby  is  caused  the  thrush. 

It  usually  comes  to  pass,  when  Children  are  fed  with  hot  paps,  which 
burns  their  mouth,  tongue,  &c.  which  carelessly  Nurses,  Maids,  or  rude 
labouring  Mothers  do  commit,  which  have  hard  skin  on  their  fingers, 
before  they  can  feel  how  hot  the  pap  is,  they  burn  the  Children,  whereby 
small  blisters  on  their  tongues  &  lips  are  caused  like  to  burnt  blisters, 
which  are  difficult  to  be  healed,  which  if  not  well  looked  to,  will  prove  the 
thrush;  therefore  care  must  be  had,  that  Childrens  food  be  not  given 
too  hot. 

6  Note  again  a  most  modern  idea.  With  the  better  understanding  of  asepsis  and 
antisepsis  came  a  craze  for  washing,  polishing,  disinfecting.  There  followed  a  period 
of  the  washing  of  infants'  mouths  under  the  most  enlightened  auspices.  The  trained 
nurse  of  the  early  antiseptic  regime  was  all  for  cleanliness — lucky  the  baby  who 
escaped  with  its  hide,  let  alone  its  mucous  membranes.  The  prevalence  of  thrush  in 
places  where  infants  were  congregated  and  of  sore  mouths  where  they  were  not,  led  to 
the  abandoning  of  this  procedure  among  the  better  informed,  and  those  who  started 
it  thought  they  had  found  a  new  thing.  Felix  Wurtz  should  have  been  consulted.  Who 
knows,  maybe  he  was! 


Objection. 
Answer. 


The  condition 
of  childrens 
mouth. 


Blisters  on  the 
tongue  cheek  or 
throat. 


How  much 
Children  are 
wronged  by  hot 
papps. 


208 


PEDIATRICS  OF  THE  PAST 


Some  customes 
to  feed 

children. 


How  children 
pets  faces  full 
of  blistrs. 


If  they  feel  an 
itch  in  their 
hands  or  feet, 
what  to  do? 


In  some  places  Children  are  fed  in  this  manner:  they  take  a  spoonful 
of  pap  out  of  the  pan ;  put  it  into  the  mouth,  then  put  it  again  into  the 
spoon,  then  they  give  it  to  the  Child:  in  this  manner  Children  are  not 
so  soon  burnt,  but  they  fumble  so  much  with  the  spoon  about  the 
Childs  lips,  which  if  no  heed  taken  will  cause  blisters  also,  which  hinders 
Children  in  their  feeding,  and  the  thrush  is  partly  caused  thereby. 

Therefore  let  Nurses  look  to  it  that  they  wound  not  the  Child  with  the 
spoon;  for  though  aged  people  may  feed  themselves  safely  with  spoons, 
as  being  used  to  it,  yet  a  Child  may  be  hurt  with  it,  being  unused  to  it : 
and  if  aged  people  may  be  hurt  with  a  spoon  at  the  eating,  much  more  a 
tender  young  Child:  and  if  a  spoon  doth  scratch  or  cut  on  the  one  side, 
it  may  do  it  on  the  other,  which  if  not  regarded,  may  soon  bring  some 
hurt. 

Moreover  they  use  to  warm  the  Childrens  pap  again  in  Butter  or  Oyl, 
and  when  that  fatness  swimmeth  above,  and  they  taking  off  some  of  it 
with  the  spoon,  then  they  blow  away  the  fatness  strongly,  not  having  a 
care,  whether  any  of  it  Ieapeth  into  the  Children's  eye  or  face :  I  have  seen 
it,  that  Children's  faces  grew  full  of  scurfe,  even  upon  that  cause,  and 
looked  as  if  they  had  been  leprous :  Item:  Children  may  be  hurt  also  in 
that  kind  with  their  Drinking  bottles,  which  in  the  end  may  prove  a 
putrifaction :  therefore  Mothers  are  to  oversee  their  Nurses  herein.7 

If  a  child  hath  an  itch  in  his  feet  or  hands,  then  it  must  not  be  kept 
too  warm,  but  must  sometimes  lye  uncovered,  else  it  can  have  no  rest 
or  sleep.  There  grows  also  little  worms  in  childrens  hands  or  feet,  which 
if  killed,  give  a  snap  like  a  nit,  these  suffer  not  little  children  to  sleep: 
many  of  these  worms  have  I  digged  out,  no  hope  for  any  rest,  which 
being  once  taken  out,  then  these  children  are  at  ease  in  their  hands 
and  feet;  and  if  children  are  bathed,  these  worms  are  drowned:  Allum 
and  Salt  maketh  them  ingender,  but  if  Sulphur  used  it  killeth  them 
quickly.  Nurses  must  look  to  it,  whether  children  be  troubled  with  such 
worms,  or  whether  onely  with  a  scurfe,  if  an  itching  one,  then  such 
children  must  be  laid  into  the  Cradle  so,  that  they  may  turn  themselves, 
they  will  the  sooner  settle  to  rest,  for  after  their  own  rubbing,  the  smart 
being  gone,  will  the  sooner  bring  them  to  sleep.  For  this  grief  in  children 
about  these  itching  worms,  no  better  thing  can  be  used,  than  a  water 
Bath  in  which  Sulphur  is  boiled  in;  it  doth  not  heal  it  so  soon,  as  when 
such  children  are  annointed  with,  in  a  dry  way.  In  case  the  child  cannot 
be  put  into  a  wet  Bath,  then  apply  the  Ointment  which  is  spoken  of 
afterward;  in  a  broad  and  long  way,  as  far  as  these  running  worms  have 
made  their  tracks,  which  Ointment  must  be  left  alone  there  for  two  daies 


7  A  wise  remark,  combining  doubtless  a  knowledge  of  the  relation  of  diet  to  the 
facial  eczema  of  infants,  and  the  dangers  of  more  serious  disorders  from  filthy  nursing 
bottles. 


FELIX  WURTZ 


209 


before  it  be  taken  off:  it  taketh  away  the  pains,  and  the  worms  are 
killed  under  it.  I  made  experiments  upon  mine  own  children,  and  found 
it  very  good.8 

Children  are  troubled  sometimes  also  with  burning  blisters,  which  are 
full  of  heat  &  pain,  these  must  not  be  let  alone  till  they  are  dryed  up, 
by  reason  of  their  tormenting  pains:  the  following  plaister  applyed  to 
it  is  very  good.  1$  of  Wax  and  Rosin  of  each  a  like  quantitie,  put  some 
Oyl  to  it,  let  these  melt  together,  spread  some  of  it  on  a  cloth,  apply  it 
and  let  it  stay  there  for  a  day,  though  some  matter  gets  out  of  it,  it  is 
no  hurt:  or,  1$  a  Honey  plaister,  or  Suet,  &c.  It  is  better  to  use  any  of 
these,  than  to  let  it  alone  naked. 

Children  are  troubled  also  with  Fellow  feeders,9  which  are  continually 
growing  at  the  back  betwixt  the  two  shoulders.  To  cure  them  of  these  I 
took  the  children  into  a  hot  Stove,  let  them  be  well  heated,  afterward 
I  annointed  their  back  with  Honey,  then  these  black  worms  crept  forth, 
which  shaved  off  with  a  Rasor,  having  iterated  it  twice  or  thrice,  then  all 
these  itchings  ceased. 

Children  are  troubled  also  with  pains  betwixt  their  thighes,  under 
their  arms,  and  near  their  privities,  at  the  making  of  water  they  feel 
smarting  pains.  Some  do  help  this  with  ravelings  of  Iinnen,  which  they 
apply  to  the  affected  places,  which  doth  no  hurt  according  as  they  do  it. 
For  some  scrape  it  off  with  a  knife,  (lint)  which  is  nought;  ravelings  of 
cloth  are  better,  the  former  stick  too  close.  Others  wash  their  children 
in  these  smarting  places  with  Wine.  Others  take  fresh  Water,  and  wash 
their  children  therewith  in  such  places,  which  in  my  opinion  is  better, 
causing  less  smarts  than  the  Wine  doth;  being  after  washing  well 
dryed,  then  annoint  the  affected  places  with  warmed  Suet,  and  with 
warm  Ointments  these  places  be  annointed,  where  there  urine  may 
come  unto.  Pomatum  is  good  also  for  the  bitings  caused  by  urin.10 

And  to  make  these  outward  means  to  be  more  effectual,  it  is  necessary, 
that  rules  prescribed  be  observed  also,  viz.  the  Mother  or  Nurse  must 
abstain  from  salt  sharp  meats,  as  red  Hearing,  pickled  Cabbage,  Barthol- 
omies  Beef;  no  Meats  of  Spices,  as  dressed  with  Pepper,  Ginger,  and 


Sharp  burning 
blisters  in 
children  and 
their  cure. 


Fellow  eaters. 


Smarting  in 
children. 


The  true  cure 
for  smarting 
pains. 


8  A  nice  description  of  itch  with  a  sensible  therapy  follows.  The  description  of 
the  burrowing  of  the  itch-mite  and  his  naive  statement  about  his  own  family  itch  are 
worthy  of  notice. 

9  The  nature  of  these  "fellow  feeders"  or  commensals,  as  the  parasitologists 
term  them,  can  only  be  surmised.  There  are  a  number  of  rare  parasites  of  some  size: 
the  guinea  worm  for  example. 

10  Here  follows  a  list  of  things  forbidden  the  nursing  mother  which  today  we  should 
recommend  for  colic  rather  than  irritating  urine,  although  the  two  may  be  associated. 
The  ordinary  foods  are  broken  down  into  the  elements  and  rebuilt  into  milk,  while 
only  the  aromatic  and  similar  substances  are  excreted  in  the  milk  unchanged  and  so 
likely  to  cause  trouble. 


210 


PEDIATRICS  OF  THE  PAST 


Running  eyes 
in  children. 


All  shining 
things  ought  to 
be  removed 
from  bad  eyes. 


Felix  Wurtz 
testifieth  what 
hurt  bright 
things  did  to 
his  bad  eyes. 


such  like  hot  spices;  for  as  the  Mothers  dyet  is,  so  the  childrens  urin 
will  be,  of  a  sharp  biting  qualitie  more  or  less.  Bayes  are  the  best  help 
for  such  pains. 

Some  Childrens  eyes  are  alwaies  running,  others  have  sore  eyes,  and 
some  of  them  have  their  eyes  clung  together.  The  which  to  remedy, 
Mothers  or  Nurses  usually  let  their  Milk  run  into  them,  of  which  I  do 
approve;  provided  that  such  Nurses  feed  not  upon  any  Garlick,  Pepper, 
Mustard,  &c. 

The  clear  Water  which  runneth  out  of  childrens  eyes,  is  less  curable 
or  stayed,  than  if  their  eyes  be  sore :  for  a  little  soreness  of  eyes  is  not 
dangerous,  but  rather  a  wholsesome  cleansing  of  the  whole  head  and 
brains:  but  the  clear  water  often  causeth  cronical  Simptoms.  In  case  the 
child  is  not  able  to  brook  any  light,  or  to  open  his  eyes,  trouble  it  not 
with  opening  of  them,  unless  the  water  in  his  eyes  cease  and  dry  up;  then 
let  his  eyes  be  opened  twice  a  day,  open  his  eye  lids  but  not  against  the 
fire,  but  onely  in  a  dark  place;  although  the  child  Iyeth  in  a  dark  place, 
yet  his  face  must  at  that  time,  be  still  more  turned  to  darkness.  Let  no 
white  clothes  hang  over  or  about  the  child,  it  would  be  hurtfull  to  his 
eye  sight;  especially  fire  and  candle  light  is  hurtful  to  his  eyes,  if  children 
be  laid  to  look  toward  or  into  it :  and  all  other  burning  things  of  a  flame, 
are  hurtful  to  such  eyes  and  cause  smarting  pains. 

Let  every  one  be  warned,  to  keep  off  every  brightness  or  heat  from 
sharp  humors  in  the  eyes,  and  not  to  suffer  that  Sun,  Moon,  Day,  Fire, 
Light,  or  any  other  whiteness  of  a  Wall,  Sealings,  &c.  give  any  shine 
to  such  eyes,  especially  to  keep  off  the  Sun  Shine,  I  found  it  by  experi- 
ence how  hurtful  hot  glimbles  of  shines  are  to  eyes :  for  one  time  being 
troubled  with  an  head  ach,  opening  my  eyes  toward  the  place  where  the 
windowes  stood  open,  looking  then  on  a  new  whitned  Wall,  thinking 
the  windowes  were  shut,  (but  stood  open  unknown  to  me)  there  strook 
a  white  glass  or  shine  so  strongly  into  my  brains,  that  I  thought  I  nere 
felt  so  great  a  pain  in  my  life.  Let  every  honest  body  be  perswaded,  to 
beleeve  that  the  like  will  be  caused  in  young  children,  and  not  suffer 
any  white  or  hot  shinings  fall  on  their  bad  eyes.  I  have  been  troubled 
with  many  infirmities  in  my  body,  but  never  felt  greater  pain  than  that 
head  ach,  caused  by  looking  on  that  new  white  Wall,  hath  brought  upon 
me:  and  was  enforced  by  these  extraordinary  pains  to  have  the  pulse  or 
temple  vein  on  the  left  side  to  be  cut,  which  all  Surgeons,  Barbars,  and 
good  friends  diswaded  me  from;  my  Wife  also  by  perswasion  suffered 
no  knife  or  other  cutting  instrument  be  brought  near  me,  and  kept  all 
such  things  from  me,  and  all  such  that  came  to  see  me,  were  intreated 
to  let  me  not  have  any  manner  of  instrument  to  cut  or  stab  withal. 
All  were  affraid  I  would  lay  violent  hands  on  my  self,  by  reason  of  the 
great  pains  I  was  in.  Thus  making  pittiful  mourn  to  Surgeons  and  all 


FELIX  WURTZ 


211 


my  friends,  on  whom  I  called  for  help,  intreating  them  to  cut  the  pulse 
vein  on  my  left  temple,  which  crying  and  calling,  I  continued  for  ten 
dayes,  those  that  heard  my  outcries,  suposed  I  did  out  of  impatience, 
for  the  which  none  would  hearken  unto  my  cries;  but  I  continued  still 
with  my  lamentation,  hoping  one  or  other  would  take  pitty  on  me:  At 
last  my  friends  considered  of  my  cries,  and  promised  in  case  any  one 
would  undertake  the  cutting  of  the  pulse  vein,  they  would  then  consent 
unto  my  demand;  I  thanked  God  that  my  cries  were  heard,  and  my 
pulse  vein  to  be  cut:  then  came  that  famous  and  conscionable  Dr. 
Cennad  Gesner,  comforted  me  and  my  familie,  and  advised  that  my 
pulse  vein  should  be  opened,  then  returned  I  thanks  to  God  again,  who 
put  this  councill  into  his  heart:  then  was  I  asked,  what  means  should 
be  used  for  the  stenching  of  that  blood,  and  incision ;  I  gave  directions 
to  the  Surgeons  then  present,  that  my  friend  and  Brother-in-law,  John 
Waser,  should  make  the  incision,  he  took  it  in  hand,  and  by  my  leave, 
and  all  the  Master  Surgeons  then  present  placed  me  on  the  beds  side,  and 
made  the  incision  at  twice  cutting,  the  wound  bleeded  vehemently, 
before  he  laid  down  the  incision  knife,  I  found  my  self  better,  for  the 
which  the  Lord  be  praised  for  ever:  thereby  was  I  delivered  from  all 
my  pains,  and  being  drest  according  to  the  direction  I  gave,  I  lost  nere 
another  drop  of  blood;  after  that  I  felt  better  in  my  head,  than  every 
I  was  in  my  life,  as  long  as  I  could  remember.  To  the  Lord  be  Praise, 
Honour  and  Glory,  for  evermore:  Amen.11 


Dr.  Gesner 
adviseth  for  an 
incision. 


John  Waser 
makes  the 
incision. 


SOME    COUNTRY    FASHION*    ABOUT   THE    WINDING   THEIR    CHILDREN    INTO 
CLOUTS,    AND  TO   LAY  THEM   DOWN    IN  THE   CRADLE 

It  is  the  fashion  in  some  Countries,  that  when  they  intend  to  lie  their 
Children  to  sleep,  they  lay  them  on  a  Table  on  a  great  pillow,  and  have 
their  woven  or  hemmed  Iinnen  swadling  clothes,  whereby  they  bind  the 
child  into  the  clouts,  from  the  arms  downwards,  but  others  begin  from 
below,  and  bind  along  upward,  and  on  the  Cradle  they  are  Iain,  whereby 
the  inlaid  Child  is  packed  up  like  a  pack  of  Wares;  this  I  do  not  much 
mislike,  provided  the  Child  be  not  tyed  or  pack'd  too  hard. 

In  other  places,  Nurses  or  Mothers  take  Children  into  their  lap, 
wrap  the  Child  into  a  woolen  cloth,  after  they  have  wrapped  them 

1 l  Here  are  several  features  common  to  the  medical  books  of  the  period.  Some  of 
these  desire  to  insert  personal  experiences;  to  descant  upon  the  unworthiness  of  the 
author  (not  a  fault  of  Wiirtz) ;  to  name  the  titled  and  honored  persons  treated.  Another 
salient  point  is  the  "to  the  Lord  be  praise,"  which  most  of  them  affect.  This  was 
doubtless  an  echo  of  the  time,  or  a  desire  to  appear  religious  in  an  age  when  religious 
belief  was  more  important  than  the  number  of  wine  bottles  in  one's  cellar.  Many  of 
our  present-day  medical  writers  seek  to  curry  favor  by  swatting  the  staggering,  if  not 
down  and  out,  John  Barleycorn. 


212  PEDIATRICS  OF  THE  PAST 

first  into  small  Iinnen  clouts,  binding  arms  and  hands  down,  and  begin 
in  their  tying  from  above  downward;  but  this  I  approve  not  so  well  of, 
as  of  the  former  way,  because  these  clouts  fall  thicker,  cause  unquietness 
to  Children,  of  the  which  more  shall  be  said  afterward;  how  Children 
are  hurt  thereby:  having  bound  and  wrapped  the  Child  thus,  then  they 
lay  it  in  the  Cradle,  and  tye  it  once  more. 

Others  lay  their  Children  only  in  clouts  into  the  Cradle,  over  that  a 
piece  of  woolen  cloth,  or  a  piece  of  ragg,  and  so  tye  it  to  the  Cradle, 
from  hole  to  hole  in  the  Cradle,  which  they  tye  very  hard;  for  if  they 
should  not  do  so,  they  beleeve  their  Child  would  not  stay  in  the  Cradle; 
even  as  the  former  too,  which  they  tye  their  Children  once  before  they 
put  it  into  the  Cradle,  and  when  it  is  put  into,  then  tie  it  once  more: 
however  let  these  things  be  done  so,  that  with  their  strong  binding  they 
do  no  hurt  to  the  Child,  for  such  hard  binding  any  aged  body  would 
hardly  endure  about  his  breast  or  heart :  I  am  assured  that  by  such  hard 
binding,  great  and  anguishing  pain  is  caused  in  their  sleep,  as  you  heard 
also  above,  about  the  sleeping  on  the  back.12 


OF   CROOKED  AND   LAME   CHILDREN,    COMING   THUS    INTO  THE   WORLD 

It  hapneth  that  a  Child  is  born  with  crooked  feet,  placed  and  pressed 
one  upon  another,  and  must  go  on  the  ancles  if  they  can;  they  usually 
say,  that  such  lame  births  are  caused  by  frights,  strange  sights,  or  by 
carelessness,  which  also  Nurses  have  to  answer  for.  These  defects  they 
say  usually  are  incurable;  it  agreeth  with  that  saying,  no  body  maketh 
himself  crooked.  These  idle  pratings  causeth  and  lazy  people,  pretend- 
ing, if  my  lame  Child  cannot  be  cured,  why  should  I  be  at  expences  or 
taking  of  pains.  It  is  a  base  and  false  excuse,  because  experience  proveth 
it  to  be  otherwise.  To  liken  this  to  an  example,  may  have  eaten  from  that 
Trees  fruit,  which  they  nursed  by  putting  the  kernell  into  the  ground; 
my  self  have  eaten  the  fruit  of  a  Tree,  six  yeers  after  I  put  the  kernel 
thereof  into  the  ground.  Even  so  is  it  with  lame  Children,  somewhereof 
I  cured  so,  that  after  some  yeers  I  saw  them  go  straight.  Let  no  man  be 
neglective  if  his  Child  be  thus  crooked,  as  not  to  ask  counsel  about  it; 
though  all  be  not  recovered  which  are  in  such  cases,  yet  many  are  cured, 
and  if  not  perfectly,  yet  may  they  be  mended  in  some  sort;  the  which 
I  do  demonstrate  with  examples.  I  have  dressed  a  new  born  Child, 
and  ordered  it  with  splinters  as  I  thought  fitting,  whose  feet  from  his 

12  The  sole  reminder  of  clouting  and  bandaging  seen  in  this  country  today  among 
the  better  classes  is  the  fetish  of  the  abdominal  binder  with  its  corollary  of  the 
necessity  of  keeping  something  in  the  way  of  flannel  on  the  "stomach"  until  after  the 
second  summer,  no  matter  how  tropical  the  weather,  or  how  unhappy  the  child. 
This,  too,  is  passing. 


FELIX  WURTZ 


213 


Mothers  wombe  stood  so,  that  the  Child  stood  on  the  outside  ancle, 
which  with  splinters  I  brought  to  right,  and  that  Child  went  as  straight 
as  any  other.13 

I  have  cured  Children,  whose  thumbs  and  other  fingers,  have  Iain  in 
their  hands  for  many  years,  tyed  them  outward,  but  did  not  break  the 
joints,  as  they  usually  say,  that  they  must  be  broken  again,  wich  is 
false,  and  he  that  saith  so  discovereth  his  silliness  in  Surgerie;  they 
ought  not  to  be  broken,  but  gently  and  steedily  be  placed  right:  for  if  a 
Child  be  put  to  pains  in  that  kind,  the  joint  will  be  inflamed  thereby, 
and  the  case  made  worse  and  more  painfull,  than  it  was  formerly.  My 
advice  is,  that  none  should  attempt  to  break,  nor  permit  any  to  do  or 
undertake  the  doing  of  it  rashly;  and  if  you  meet  with  one  that  give 
reasons,  the  thing  might  be  done  without  pains,  and  that  in  such  a  way 
the  cure  might  be  performed,  then  follow  his  advice:  but  he  that  saith 
that  first  of  all  such  joints  must  be  fomented,  bathed,  annointed,  he 
goeth  the  contrary  way  to  work,  for  thereby  the  joint  is  not  made  soft 
but  stiffen  But  if  Childrens  ancles,  knees,  feet,  fingers,  &c.  are  so  hard 
and  ugly,  that  they  must  be  first  of  all  mollifyed,  then  such  medicines 
may  do  something.  And  so  I  speak  here  not  of  all,  but  of  such  which  are 
curable. 

Therefore  observe,  whether  that  joint  doth  bow  and  turn  easily  to 
the  place  where  it  should  be,  then  bind  it  that  way,  and  cure  it.  Some  of 
such  joints  will  easily  turn  and  bow,  but  that  is  not  enough;  binding  is 
for  such  a  joint  the  better,  the  growing  whereof  bringeth  forward  the 
cure  and  not  the  bowing  or  setting;  the  bowing  of  it  is  good,  but  it  is 
not  all,  but  it  must  be  set  and  laid  right  also,  then  the  one  helps  the  other, 
and  the  growth  in  time  is  brought  on:  though  little  amendment  is  seen 
in  a  week,  moneth,  or  three  moneths,  yet  a  whole  years  time  may  produce 
something,  and  in  time  perfectness  comes  in.  But  how  to  set  and  bind 
crooked  joints,  is  not  possible  to  set  down  every  particular  thereof,  the 
Surgeon  must  take  notice  and  observe,  which  way  his  splinters  and  other 
things  will  sit  best. 

No  splinter  must  be  too  close  applyed  here,  neither  must  they  be 
bound  too  hard;  if  too  hard,  and  the  Child  cryeth  out  by  reason  of  the 
pains  it  feels,  then  instantly  tie  it  slacker,  for  such  pains  would  cause 
great  mischief:  therefore  bind  such  joints  softly  and  gently,  according 
to  the  place.  For  a  foot  is  and  must  be  tyed  more  strongly  than  a  hand, 
and  a  hand  can  endure  a  band  more  strongly  tyed  than  a  finger,  conceave 
thus  of  the  rest  of  the  joints.  The  stronger  a  joint  is,  the  better  is  it  able 


No  crooked 
joint  oughtjto 
be  broken,  but 
plainly  to  be 
set  right. 


How  to  set  and 
dresse  crooked 
joints. 


Some  joints 
are  bound  hard, 
some  slack. 


13  A  fine  talk  on  a  much-needed  subject.  More  appropriate  then,  than  now,  but 
the  number  of  deformed  people  in  the  street  today,  who  would  have  been  straight  had 
any  one  known  how  to  deal  with  their  infirmity  in  time,  makes  one  want  to  publish 
this  in  the  daily  papers,  along  with  some  of  the  "sure  cures"  and  "strength-producers." 


2i4  PEDIATRICS  OF  THE  PAST 

to  endure  a  stronger  band:  and  again  the  less  a  joint  is,  the  worse  it  can 
endure  a  band. 

You  are  to  observe  exactly,  when  there  cometh  into  any  joint,  pains, 
redness,  smartings,  blewishness  or  collositie,  a  swelling  or  the  like 
simptome,  then  is  it  very  hurtful  and  dangerous;  for  then  you  have 
bound  it  too  hard,  unbind  it  presently,  the  Quids  welfare  Iyeth  herein, 
if  not  his  life:  for  these  joints  cannot  endure  any  pain;  this  you  ought  to 
take  good  notice  of. 

This  is  my  faithful  advice,  that  you  do  not  deal  too  hard  with  it,  at  the 
first  you  ought  to  bind  it  gently,  then  you  may  soon  perceave,  whether 
you  are  or  may  proceed  further  and  more  hard  in  it.  For  in  such  cases 
Surgeons  must  not  presently  go  on,  as  they  ought  to  do  in  fracture 
bindings;  in  case  it  doth  fit  here  the  first  time,  then  you  are  to  let  it  rest, 
and  not  to  trouble  your  self  nor  the  Child  any  further,  if  it  fitteth  well 
at  the  first  time,  then  go  on,  in  few  weeks  you  will  perceave  the  amend- 
ment thereof,  you  may  alter  the  band  as  the  defect  requireth. 

When  you  are  to  dresse  a  Childs  crooked  joint,  then  take  my  red 
plaister,  which  groweth  stiff  and  hard,  sticketh  closely,  and  as  you 
measured  your  splinters,  then  take  the  plaister  spread  on  a  cloth,  apply 
it  on  the  splinters,  that  it  may  stick  thereunto,  and  cover  the  splinter 
well  in  the  inside,  then  that  band  holdeth  fast;  for  it  keepeth  the  splinters 
so  fast  together,  as  a  Saddle  holds  firmly  which  is  glued  together.  The 
overplus  of  the  Plaister,  which  goeth  or  runneth  beyond  the  splinters, 
you  cut  off  and  spread  the  Plaister  there  on  the  splinters,  as  you  used  to 
do  at  a  fractures  dressing  with  splintures  spread  with  the  Plaister,  then 
apply  a  Plaister  to  the  lame  joint,  yet  not  so  close  together  as  to  have 
them  laid  one  on  another,  as  I  advised  you  in  my  second  part  of  Surgerie 
touching  bone  fractures :  in  fractures  it  must  not  be  laid  so  close  together, 
as  in  these  little  joints,  because  these  joints  neither  swell  nor  consume, 
if  pulled  not  too  hard  but  gently:  it  is  better  they  be  bound  slack  a 
whole  week,  than  too  hard  one  hour.  Then  apply  your  measured  splinters, 
you  need  but  two,  and  not  three,  four,  or  more,  which  other  fractures 
require.  Then  bind  this  joint  as  it  fitteth  in  the  bowing,  and  let  it  rest 
thus  bound  ten  or  fourteen  daies,  as  you  see  occasion:  you  need  not  to 
fear  any  simptom  here,  if  you  bound  it  not  too  hard,  nor  too  untimely, 
and  do  as  you  did  formerly;  if  the  case  be  altered  and  mended,  then  your 
splinters  and  binders  must  be  accordingly  altered:  and  there  is  not  any 
Craft  worse  to  be  described  than  even  this,  as  how  one  should  prepare, 
keep  and  behave  him  in  his  splinters  and  bands,  it  is  a  thing  almost 
impossible:  I  have  often  practised  it,  and  had  good  success  therein: 
God  be  praised  forever:  Amen. 


FELIX  WURTZ  215 

The  whole  business  and  manuals  are  comprehended  in  these  Verses. 

Have  a  care  you  bind  the  Joint  not  too  hard, 

then  surely  is  done  neither  hurt  nor  smart. 
Do  not  begrudge  your  time  at  all, 

a  timely  cure  on  the  party  will  fall. 
Be  exact  with  your  tying  and  setting, 

then  the  crooked  joint  will  right  come  in. 
Give  not  over,  be  willing,  not  timorous, 

the  Joint  grow'th  right  as  a  wick  most  curious. 

OF    CROOKED    AND    DISLOCATED    LEGGS,    CAUSED    BY    CARELESS    LAYINGS, 

AND   OF  THEIR   CURE 

I  have  seen  Children  born  straight,  yet  became  lame  and  crooked, 
and  could  not  be  healed  straight  again;  their  Mothers  or  Nurses  told 
me  of  the  manner,  how  they  became  to  be  thus  lame  and  crooked:  I 
bid  them  many  times  to  untie  the  Child,  and  to  tie  and  bind  it  again, 
to  see  the  manner  of  it;  where  I  then  quickly  perceaved,  in  what  they 
had  missed,  which  was  done  and  committed  in  binding,  as  I  spoke  of 
it  above:  for  they  lying  the  Child  in  their  lap,  and  toward  the  feet  bind- 
ing it  so,  that  the  Child's  knees  come  together  in  lying,  and  puts  some 
Boulsters  betwixt,  and  will  not  leave  the  birth  as  God  hath  created  it, 
will  have  their  Children  yet  handsomer,  by  binding  them  straighter  to 
their  thinking,  tye  and  bind  them  more  crooked,  doing  it  too  hard, 
which  maketh  the  Child  unquiet,  turns  and  winds  himself  so  long,  till 
he  gets  somewhat  loose,  in  this  way  the  Child  groweth  like  a  twigg, 
according  as  it  was  tyed.  But  by  the  help  of  God  the  like  cases  may  be 
remedied,  and  my  self  have  done  many  such  cures,  when  Children  were 
spoiled  with  such  untoward  bindings,  and  had  carryed  it  on  above 
sixteen  years  long;  as  long  as  they  are  growing,  so  long  are  they  in  the 
state  to  be  mended  and  set  straighter:  when  Children  are  bound  straight 
with  strong  binding,  then  they  usually  grow  crooked;  and  none  will 
grow  more  straight  in  his  body,  than  those  which  are  laid  free  and  loose 
with  their  hands  and  feet:  therefore  my  advice  is,  not  to  use  any  curiousi- 
ties  at  the  laying  and  binding  your  Children,  unless  there  be  some 
miscreance,  or  other  unshapedness  about  them,  then  is  it  reason  and  time 
to  advise  with  good  Surgeons,  who  will  tell  you  how  these  faults  are  to 
be  ordered  and  mended,  and  let  not  people  follow  onely  their  own 
counsel  and  fancies. 

Some  reply  here;  I  am  fain  to  tie  and  bind  my  Child  hard,  by  reason 
of  his  scabbie  feet,  if  I  do  not  so,  then  it  rubs  them  together,  and  maketh 
them  smart,  and  then  it  cannot  be  quieted. 

Others  which  have  no  skill  how  to  bind  them  right,  say,  though  I 
bind  my  Child  hard,  yet  it  slideth  and  slippeth  out  of  the  band,  which 


2l6 


PEDIATRICS  OF  THE  PAST 


What  hurts 
Children  gets, 
if  not  covered 
about  the 
shoulders. 


A  fit  garment 
for  Children  to 
wear  in  their 
Cradles. 


To  cast  up 
Children  and 
catch  them  is 
an  ill  fashion. 


causeth  me  to  wrap  and  bind  it  harder:  these  neither  mind  nor  care 
what  or  how  then  go  about  it,  not  how  they  should  do  it,  neither  will 
they  advise  with  others  about  it,  but  go  on  obstinately  in  their  ill 
accustomed  waies;  binding  their  Childrens  shins  together,  making  them 
lame  and  creeple.  Therefore  I  advise  you  to  take  better  course  in  these 
bindings,  and  chiefly  above  about  the  breast  and  heart,  not  to  put 
Children  to  miseries  that  way. 

Further  I  counsell  Mothers  and  Nurses  not  to  bind  their  clouts  too 
strongly  together  at  the  end  of  their  feet,  which  maketh  Children  lame 
in  their  going  or  standing.  If  Childrens  shoulders  are  left  open  or  uncov- 
ered, it  is  great  hurt  to  them,  by  reason  of  the  pores,  which  are  more 
open  than  aged  peoples,  because  their  skin  is  very  tender:  it  is  a  pain 
to  them  all  night  long,  especially  in  frosty  nights,  and  when  they  come  to 
age,  they  are  full  of  rheums,  have  heavy  arms,  and  grow  lame  in  their 
hands,  shoulders,  elbowes,  and  about  the  upper  parts  of  the  body,  about 
the  head,  the  eyes,  the  sinews  all  the  body  over,  in  their  hearing,  and 
pains  in  their  back  bone.  Never  more  complaints  made  by  men  but  about 
such  lamenesses,  when  they  took  cold  in  their  young  years,  lying  thus 
uncovered  in  their  Cradles. 

To  prevent  these  several  inconveniences  and  hurts  incident  to  Chil- 
dren, my  advice  is,  that  Childrens  caps  and  sleeves  should  be  all  of  one 
piece,  or  sowed  together:  for  a  cap  of  it  self,  and  sleeves  apart,  though 
they  cover  the  parts  they  are  made  for,  yet  the  Child  is  not  all  covered 
that  way:  but  if  cap  and  sleeves  be  sowed  together,  as  one  piece,  it  is 
the  best  way:  though  the  Child  pulls  his  hand  out  of  the  cradle,  yet  are 
his  shoulders  covered;  and  cover  the  heart  and  stomach  of  the  Child 
the  better,  and  his  clothes  must  be  made  the  wider,  that  they  may  fall 
one  over  another,  and  lye  double. 

This  in  my  opinion,  is  a  proper  garment  for  a  Child  to  lay  in,  in  the 
Cradle,  then  there  is  no  need  of  the  strong  band  above  about  the  body, 
and  are  thus  best  covered  and  guarded  from  cold.  And  that  you  may  not 
need  to  tye  the  Child  too  strong  about  the  feet,  then  take  great  and  long 
clouts,  which  may  go  about  the  feet  twice  double,  and  lay  other  Iinnen 
between  the  ancles  to  keep  them  assunder :  and  if  you  will  not  bind  the 
Child,  yet  lye  it  warm,  so  that  the  feet  may  not  touch  or  rub  one  against 
another:  if  such  great  and  long  Iinnen  may  not  be  had  of  every  one, 
then  let  them  use  other  clouts,  provided  they  cut  off  the  ravelings  about 
them,  which  tickle  the  skin,  and  cause  a  rubbing.  Some  people  hath 
that  ill  and  base  custime,  they  flint  with  one  hand  the  Child  upward,  and 
catch  it  with  the  other,  which  can  cause  not  other,  but  that  such  Chil- 
dren usually  take  frightnings  in  their  sleep,  because  that  dancing  in  the 
Nurses  hands  comes  to  them  in  their  sleep  by  imagination,  thinking 
they  are  leaping  or  jumping  in  their  Nurses  hands.  The  like  befalls  aged 


FELIX  WURTZ  217 

people,  who  having  been  on  a  dangerous  tempestious  Sea,  in  their  sleep 
they  are  horribly  frightened,  thinking  they  are  in  that  dangerous  Sea  still. 

Though  Children  are  not  so  much  frightened  by  that  dancing,  yet 
there  are  other  sports  for  them  to  be  dallyed  withall,  for  it  falls  out  some- 
times, that  Children  in  that  dancing  are  let  fall,  which  can  it  be  done  with- 
out hurt  unto  the  Child?  I  have  seen  a  Father  taking  his  little  boy  by 
the  shoulder,  and  threw  him  upward,  the  sport  pleased  the  boy  very 
well,  desired  his  father  to  do  it  again  and  again;  this  pastime  pleased 
Father  and  Son  for  a  while,  but  one  time  the  boy  being  flung  too  high, 
and  turning  in  that  flinging  came  out  of  his  Fathers  reach,  fell  down 
behind  his  Father,  who  was  not  able  to  stay  him  then  in  his  fall.  This 
sport  was  turned  into  lamentation. 

Some  daunce  their  Children  on  their  lap,  with  their  legs  outstretched,   ^nstdancing 
and  these  regard  not  the  tenderness  of  their  Ieggs  and  sinewes;  in  that  childfentoo 

•  T  f      I  *T  t  r  t       mucn  on  the 

way  of  dancing  these  little  ones  may  easily  receave  hurt.  After  such  knee  or  lap. 

dancing  they  lay  the  Child  down,  when  the  next  day  the  Child  is  taken 

up,  then  is  it  sore,  cryeth,  cannot  endure  such  dallying,  or  be  toucht  or 

carryed  about:  then  they  say,  I  wonder  what  aileth  my  Child,  I  laid  it 

last  night  well  and  sound  into  the  Cradle,  and  was  cheerfull,  and  could 

dance  in  my  lap,  now  it  cryeth,  if  I  do  but  touch  it:  thus  they  blame  the 

innocent  Child,  when  themselves  are  in  fault.  Then  they  bring  it  to  the 

Surgeon,  saying,  pray  see  what  my  Child  aileth,  for  it  can  neither  stand 

nor  go,  and  yet  nothing  is  seen  about  it,  no  sign  or  spot  at  all  about  his 

skin,  I  cannot  conceive  what  hurt  it  should  have  received;  I  fear  it  is 

bewitched,  &c.  If  a  Surgeon  saith  some  luxation  hath  befallen  this  Child, 

or  it  is  handled  roughly,  or  hath  been  over  playd:  they  reply,  Oh  no!  our 

Child  was  not  hurt  of  us;  and  will  not  confesse  their  apish  play:  if  they 

would  confesse  their  fault,  then  their  Child  might  the  sooner  be  cured. 

My  advice  is  this,  use  no  apish  tricks  to  your  Children,  let  them  keep 

that  health,  which  God  hath  bestowed  on  them,  not  to  pull  or  to  hale 

them  from  one  place  to  another,  with  dancing,  jumping,  juggling,  &c. 

and  playing,  like  as  the  Cat  doth  with  a  Mouse :  for  these  tricks  wrongeth 

Children  so  much,  that  when  full  grown,  it  is  seen  then  what  hard  shifts 

they  are  put  to,  to  do  their  works. 

The  like  befell  my  eldest  Son,  it  is  a  pitty,  and  all  those  that  know  him 
do  pitty  him ;  for  he  is  quite  disabled  to  do  any  work,  and  must  continue 
so  as  long  as  he  Iiveth,  onely  upon  such  an  accident  as  I  told  now;  which 
held  him  to  the  twelfth  year  of  his  age,  and  it  was  concealed  from  me 
that  he  had  it  from  such  dancing:  if  they  had  confessed  it  in  time,  that 
with  that  kind  of  sporting  it  was  caused,  then  by  Gods  assistance  I  might 
have  cured  him.14 

14  One  questions  whether  these  rather  sudden  losses  of  power  are  not  in  part 
poliomyelitis. 


2l8 


PEDIATRICS  OF  THE  PAST 


Children  are 
hurt  by  un- 
toward carry- 
ing of  them. 


When  children 
ought  to  be 
carried  on 
arms. 


At  this  present  I  cease  to  write  any  more  of  such  apish  tricks,  juglings, 
jumpings,  which  they  practise  upon  Children;  and  who  can  rehearse 
all  the  hurts  done  thereby  unto  them?  the  one  gets  a  lameness  by  that 
jumping,  and  dancing,  another  is  put  into  frights  which  is  seen  and 
observed  at  nights;  and  some  are  quite  put  to  Convulsion  fits;  another 
Iooseth  his  sight;  another  his  hearing;  and  many  other  hurts  are  done  by 
several  such  tricks,  which  I  forbear  to  relate,  for  fear  they  should  be 
practised. 

Sometimes  I  found  a  fracture  on  a  Childs  Iegg,  or  arm,  or  a  crack;  and 
when  I  said  the  Child  received  this  or  that  hurt,  and  talking  to  them  of 
it  which  had  the  oversight,  they  durst  not  confess  how  the  Child  was 
hurt,  fearing  their  Masters  and  Mistresses  displeasure,  when  the  Child 
was  cured,  then  the  neighbours  Children  would  say,  how  the  Child  was 
hurt  at  such  a  time.  Sometimes  they  cannot  tell  what  the  Child  aileth, 
though  it  hath  received  hurt  from  another;  and  those  Nurses  or  Maids 
which  were  to  look  to  the  Children,  though  they  outstand  it  most  that 
the  Child  was  not  hurt,  where  found  to  be  the  onely  fault  of  that  hurt 
the  Child  received;  but  when  they  say  the  Child  do  well,  and  was  cured, 
then  they  bewray  it,  what  hitherto  they  have  kept  close,  Children  when 
carryed  about,  may  soon  be  hurt  in  such  a  manner,  that  they  can 
never  be  helped  again. 

In  some  places  Children  are  carryed  about  in  mantles  or  Table 
clothes,  as  at  Bambury  and  Forchheym  I  have  seen  it:  in  this  way 
Children  may  be  hurt  least,  if  carryed  onely  in  the  arm,  and  slencker'd 
up  and  down  by  lazy  Maids  are  easily  hurt  in  that  manner.  I  have 
espyed  the  like  mischiefs  done  to  Children  by  such  rude  carrying,  but 
durst  not  reprove  them  for  it,  these  impudent  wenches  would  have 
outfaced  me  therein.  Some  Childrens  back  bone  have  I  seen  crackt  in 
two,  and  the  verticles  thereof  were  disjoyned,  and  removed  so  far, 
that  they  could  never  be  brought  together  again,  or  if  joyned,  could 
not  be  kept  so  long,  if  that  once  hapneth  to  Children,  then  they  go 
bowed,  and  their  head  almost  between  their  thighes,  or  else  they  halt 
or  limp  on  both  sides.  This  comes  from  a  careless  carrying  Children 
abroad  and  about.15 

Therefore,  be  warned,  not  to  carry  Children  abroad  too  soon,  before 
his  back  bone  and  sinewes  be  strong  enough;  unless  the  party  that  is  to 
carry  it  knoweth  well  to  handle  a  Child  in  carrying,  and  to  stay  the 
Childs  back  with  her  hand;  let  it  be  carried  as  well  as  it  may,  yet  it  soon 
falls  out  that  a  Child  gets  a  division  or  strain  in  the  back,  which  may 
prove  a  great  inconvenience  to  the  Child.  Little  Maids  are  sometimes 
instructed  to  carry  a  Child,  a  Child  overturning  himself  or  Ienting 


15  Old  Felix,  of  course,  completely  missed  tuberculous  caries  of  the  spine.  Not  his 
fault,  but  that  of  his  age  and  a  lack  of  autopsies. 


FELIX  WURTZ 


219 


backward,  that  girle  is  not  able  to  stay  the  Child,  by  this  means  little 
Children  may  soon  get  hurt. 

Children  commonly  are  carryed  on  one  arm,  as  those  usually  do, 
which  are  wont  to  carry  onely  on  the  right  arm,  and  never  change  the 
Child  from  the  right  to  the  left  side,  or  arm,  and  again  from  that  to  the 
right  arm,  the  which  is  hurtfull  also  unto  Children:  for  I  know,  that 
when  Children  are  carryed  onely  on  one  side,  then  that  Iegg  Iyeth  closer 
to  the  body  than  the  other,  and  is  caused  to  grow  crooked,  even  as  a 
twigg  on  a  tree,  which  is  bowed  either  straight  or  crooked. 

Therefore  let  Children  be  changed  from  one  side  to  the  other  in  the 
carrying  to-day  on  this,  and  to-morrow  on  that  side,  and  not  still  on  one 
alone. 

Some  Mothers  have  the  custome,  that  they  place  their  children 
by  times  in  a  stool,  purposely  made.  Others  let  their  Child  sit  in  the 
elder  childs  lap.  Others  place  their  Child  with  clouts  into  a  tub.  Be  it 
in  what  manner  it  will,  I  advise  no  body  to  use  his  Child  too  soon  to 
sitting,  because  the  childs  body  above  is  heavier  than  his  nether  part, 
and  all  the  weight  of  it  Iyeth  on  his  back.  Some  Children  are  weaker  in 
their  backs  and  sinewes  than  others;  therefore  it  is  not  adviseable  to 
place  Children  too  soon  into  stooles,  or  other  sitting  places.  To  set  it 
upright  in  the  cradle,  and  to  stay  his  back  withal,  or  to  place  it  on  a 
pillow  near  the  harth  or  chimney,  is  the  better  way.  The  longer  you  stay 
with  the  child  in  that  kind,  the  better  strength  it  gets,  even  in  sitting 
before  another  Child.  As  we  see  a  twigg  inoculated  this  year,  groweth 
as  fast  as  that  which  was  ingrafted  the  other  year  before  that.  The  same 
condition  it  hath  with  a  Child,  his  back  groweth  strong  in  that  time, 
and  the  less  danger  is  it  subject  unto,  which  if  too  soon  used  to  sitting, 
parents  must  still  be  affraid  that  it  will  take  hurt.  Though  a  child  is 
able  to  sit,  yet  for  many  reasons,  it  is  naught  for  it,  to  have  it  sit  long. 

Therefore  as  I  mentioned  above,  the  child  is  to  be  laid  on  the  back, 
and  let  it  lye  so  untyed  or  bound  playing;  this  way  is  best  for  such 
children,  which  are  not  agazed  at  their  feet  and  hands,  when  they  thus 
play  on  their  back;  but  if  they  be  so  young,  that  their  own  feet  or  hands 
may  terrifie  them,  then  they  ought  not  be  laid  unbound  or  open. 

Touching  the  standing  of  children,  there  are  stools  for  children  to  stand 
in,  in  which  they  can  turn  round  any  way,  when  Mothers  or  Nurses 
see  them  in  it,  then  they  care  no  more  for  the  child,  let  it  alone,  go  about 
their  own  business,  supposing  the  child  to  be  well  provided,  but  they  little 
think  on  the  pain  and  miserie  the  poor  child  is  in,  in  that  standing. 
Take  an  example  from  an  aged  man,  which  standeth  but  an  hour  in 
a  place,  either  in  the  pulpit  or  else  where,  that  time  seems  long  to  them; 
what  shall  we  think  of  the  poor  child,  which  must  stand  may  be  many 
hours,  whereas  half  an  hour  standing  is  too  long  for  such  a  child.  I  wish 


Children  not  to 
be  carryed 
alwaies  on  one 
side. 


To  govern 
children  in 
their  sitting. 


The  standing 
of  children. 


220 


PEDIATRICS  OF  THE  PAST 


Children  are 
hurt  in  stand- 
ing too  long. 


Childrens  run- 
ning wagons. 


Bowes. 


Overspread 
clothes. 


that  all  such  standing  stools  were  burn'd,  and  that  never  any  were  made, 
by  reason  of  the  great  misery  that  Children  endure  from  such  standing: 
for  I  hold  these  stools  a  mere  prison,  or  stocks  for  poor  infants;  I  do  won- 
der many  times,  what  merciless  fool  that  was,  who  invented  that  rack 
at  first,  to  make  a  Child  stand  above  an  hour  in  that  tub.  I  found  many 
times,  that  when  such  Children  overstood  themselves  in  that  tub,  sunck 
down  where  they  lay  a  long  time,  and  there  they  lost  their  strength, 
which  were  brought  to  me  afterward  to  recover  and  cure  them :  Children 
should  not  be  made  stand  on  their  feet,  before  they  are  half  a  year  old, 
and  be  strong  enough  in  their  sinewes;  and  coming  from  such  a  cure, 
they  must  rest  half  a  year,  then  they  grow  strong  again,  and  Nature  will 
be  aiding  unto  them,  neither  is  there  any  medicine  to  be  used,  onely 
they  must  be  kept  warm  and  quiet.  I  made  use  sometimes  of  Oxycroceum 
Plaister,  and  three  moneths  after  I  made  a  warm  Bath,  put  them  in, 
thereby  I  recovered  them  to  their  full  strength.  Children  that  are  forced  to 
such  standing,  commonly  grow  lame,  and  limp  on  both  sides.  I  never 
saw  any  good  done,  when  children  were  taught  to  stand  or  to  go,  before 
they  had  any  sufficient  strength  to  it :  my  advice  is,  not  to  put  Children 
too  soon  upon  standing,  but  if  Nature  be  forward  in  them,  then  they 
may  venture  the  sooner. 

There  are  running  stools  for  Children  made,  in  which  they  do  not 
onely  stand,  but  go  also;  in  these  stools  the  Children  can  hold  out  longer, 
because  they  can  stir  and  move  in  them. 

I  must  speak  also  a  word  or  two  about  the  covering  of  childrens 
faces  to  keep  off  the  flies  from  them.  Some  lay  a  white  cloth  over  them ; 
others  doubles  such  clothes,  enough  to  stifle  the  child  under  it,  which  in 
my  opinion  is  an  ill  custome;  Others  set  bowes  over  the  cradle  and  hang 
clothes  over  them,  which  I  hold  to  be  good,  because  the  children  are  not 
touched  by  the  clothes  that  are  hanged  over,  neither  can  they  well  be 
frightned  by  them:  these  please  me  the  better,  if  the  clothes  hanged 
over  are  so  thin,  that  the  childrens  breath  can  have  way  to  go  though, 
and  if  such  clothes  be  either  of  a  blew  or  green  dye,  they  are  the  better 
for  their  eye-sight:  pure  Scarfes  or  Tiffmies  are  good  for  that  purpose. 

Some  careless  people  do  not  cover  their  childrens  faces  at  all;  if  done 
out  of  neglect  and  carlesness,  are  worthy  of  reproof. 

This  much  of  childrens  infirmities.  Let  all  be  to  Gods  Glory,  and  the 
good  of  Children:  Amen. 


FINIS 


HIERONYMUS  MERCURIALIS 

[1530- 1 606] 

MERCURIALIS  was  born  at  Forli,  September  30,  1530,  and 
after  studying  medicine  for  some  years  at  Bologna  received 
his  doctor's  degree  at  Padua.  He  then  returned  to  his  native 
village,  where  he  might  have  remained  in  obscurity  for  the  remain- 
der of  his  days  had  not  his  fellow  townsmen  chosen  him  to  represent 
them  in  an  important  political  mission  to  Pope  Pius  iv.  His  errand 
over,  he  was  importuned  by  Cardinal  Farnese  to  stay  in  Rome.  A 
scholar  such  as  Mercurialis  probably  did  not  think  twice  in  making 
the  decision  to  remain  in  a  city  which  was  a  veritable  treasure 
house  of  the  works  of  the  early  writers.  His  next  seven  years  were 
spent  in  studying  the  writings  of  the  ancient  and  medieval  authors 
and  doubtless  he  might  have  spent  his  life  in  such  literary  research 
had  not  Antonio  Fracanzoni,  called  the  Aesculapius  of  his  time, 
died  leaving  vacant  the  chair  of  medicine  at  Padua.  Mercurialis 
was  invited  to  fill  the  vacant  professorship  and  remained  in  that 
capacity  until  1587,  when  he  went  to  Bologna  to  occupy  the  chair 
of  medicine.  In  1599  he  changed  again  to  Pisa  where  he  stayed 
until  a  short  time  before  his  death,  which  occurred  on  November 
13,  1606,  at  his  native  town  of  Forli.  He  died  as  the  result  of  a 
renal  calculus,  the  diagnosis  of  which  he  made  himself  and 
which  was  confirmed  by  autopsy.  His  fellow  citizens  erected  a 
statue  in  a  public  square  in  memory  of  their  famous  townsman. 

Mercurialis  enjoyed  a  reputation  as  a  physician  far  beyond  the 
cities  in  which  he  lived  and  in  1573  the  Emperor  Maximilian 
called  him  to  Vienna  to  consult  him,  and  for  this  visit  Mercurialis 
was  rewarded  with  the  title  of  a  palatine  count. 

He  wrote  prolifically  on  all  sorts  of  subjects.  He  ranged  from 
psychiatry  to  gynecology,  he  wrote  on  skin  diseases,  on  affections 
of  the  eye  and  ear,  hydrophobia,  plague,  balsams  and  poisons. 
His  chief  fame  rests  in  his  work  on  the  gymnastics  of  the  ancients 
compiled  from  various  sources  and  his  commentary  on  Hippoc- 
rates to  which  he  brought  great  diligence  and  learning. 

221 


222  PEDIATRICS  OF  THE  PAST 

Concerning  "De  Arte  Gymnastica"  an  unsigned  article  in 
La  Chirurgia  degli  Organi  de  Movimenti1  speaks  of  it  as  a  cradle  of 
orthopedics.  Mercurialis  was  so  immersed  in  the  writings  of  earlier 
days  as  to  lead  the  same  writer  to  state  that  Mercurialis  remained 
a  prisoner  in  the  past  as  if  he  were  in  an  immense  building  without 
a  window.  He  also  says: 

His  mill  was  turned  by  waters  from  springs  strikingly  dissimilar. 
He  took  not  only  from  philosophers,  historians,  mathematicians  and 
orators,  but  from  pagan  moralists  to  the  holy  Fathers,  he  turned  to 
gnomic,  epic,  dramatic,  lyric  and  satirical  poets.  Vitruvius  entered  in 
company  with  Aristophanes  and  Lucian;  the  satyricon  of  Petronius  is 
cited  equally  with  the  Evangels  of  Jesus;  the  turpitudes  of  Martial  like 
the  grandeurs  of  Virgil  and  Homer. 

The  pediatric  writings  are  two  in  number,  the  first,  "Nomo- 
thelasmus  seu  ratio  Iactandi  infantes. "  Padua,  1552,  would  be  of 
great  interest  in  view  of  the  present  interest  in  infant  welfare.  The 
writer  has  never  seen  a  copy.  His  other  pediatric  contribution, 
"De  Morbis  Puerorum  tractatus  Iocupletissimi,  etc,"  was  printed 
at  Venice  in  1583,  1584  and  15 16.  It  was  translated  into  German  by 
Uffenbach  and  printed  in  Frankfurt,  1605. 

This  work  was  not  actually  written  by  Mercurialis  but  by  one 
of  his  students  and  the  title  page  states:  "Ex  ore  Excellentissimi 
Hieronymi  Mercurialis  Forliniensis  Medici  clarissimi  diligenter 
excepti,  atque  in  Libros  tres  digesti :  Opera  Johannis  Chroscziey- 
oioskii  cum  Iicentia,  et  priviIegio.,,  (Tractates  on  Children's 
Diseases,  very  complete  and  filled  with  various  learning,  very 
useful  not  only  to  Doctors,  but  also  to  Philosophers;  carefully 
taken  down  from  the  mouth  of  the  Most  Honorable  Geronimo 
Mercuriali  of  Forli,  the  famous  Doctor,  and  digested  into  three 
Books.) 

This  worthy  student  has  had  his  name  somewhat  scrambled 
by  the  bibliographers,  but  small  wonder. 

It  is  divided  into  three  parts,  viz. :  On  the  diseases  of  children, 
on  the  fevers  of  children  and  on  worms.  The  later  editions  include 
the  letter  of  Alexander  Trallianus  on  worms. 

Hennig  and  Garrison  do  not  think  a  great  deal  of  it,  but  on  the 
other  hand  von  Bokay  calls  it  the  first  real  book  on  diseases  of 
children,  adding  that  from  a  professional  point  of  view  it  was 
negligible.  He  quotes  Hennig:  "Dies  unbedeutende  Buch  gait 

1  Bologna,  n,  259,  1919. 


gpyr^^^^^  m2^f^j) 


Hieronymus  Mercurialis. 


DE  MORBIS 

PVERORVM 

TRAC TAT VS 

LOCVPLETISSIMI, 

vVamqj  do&rina  referri  nonfolum Media's,  verum- 
etiam  Philofophis  magnopere  vtiles  > 

€xorc'Excellenti£imiHierommiAdercurialisForolit4ienfis 

Medici  clarifimi  diligent  er excepti,at(\ue 

in  Librostres  digefii : 

Opera  Iohannis  ChrofczieyoiosWj 
CVM  LICENTIA,  ET  PRIVILEGIO. 


Venetijs,Apud  Paulum  Meietum  Bibliopolam  Pat. 
M.     D.     L  X  X  X  I  I  I. 

Title  page  of  Mercurialis*  book  on  "Diseases  of  Children." 


HIERONYMUS  MERCURIALIS  225 

Iange  als  Massgebend. "  (This  insignificant  work  was  long  con- 
sidered  authoritative.) 

It  is  long-winded  and  full  of  references  to  authorities.  The 
chapter  on  stammering  is  one  of  the  best  known  parts  and  this 
was  reprinted  in  German  some  years  ago.  It  is  a  good  example 
of  the  writing  of  Mercurialis  and  indeed  of  the  period.  If  one 
wished  one  could  read  into  this  chapter  some  very  modern  ideas 
concerning  stammering.  The  translation  of  this  chapter  is  by 
Dr.  Herbert  F.  Wright. 

Tractate  on  Children's  Diseases  by  Geronimo  Mercuriali 
chapter  viii.  on  stammering 

There  follows  the  impediment  of  speech,  whether  noyt,\a\ia  or 
ayyi\oy\ov<ns.  There  are  two  causes  of  this  affection:  one,  native;  the 
other,  accidental  or  through  disease.  The  native  cause,  as  Galen2  shows, 
is  an  unnatural  connection  of  the  tongue  with  the  underlying  parts, 
and  this  connection  occurs  very  frequently  in  children.  The  cause 
through  disease  is  either  a  swelling  underneath  the  tongue,  as  in  ranula, 
or  a  scar  left  from  a  wound  of  that  part.  There  are  no  other  causes  of  this 
disease  than  those  proposed,  which  are  mentioned  also  by  Aetius.3 

There  is  a  third  fault,  which  is  stammering  or  faulty  speech.  Although 
this  has  three  species,  the  cause  of  each  species  concerns  the  impairment 
either  of  the  faculty  or  of  the  instruments.  The  faculty  is  impaired,  when 
either  the  cerebrum  itself  is  disturbed  by  some  immoderation  or  the 
faculty  itself  is  prevented  from  being  able  to  proceed  to  move  the  tongue 
properly.  Immoderation  in  the  cerebrum  occurs  in  intoxication,  for 
Galen4  said  the  intoxicated  stammer  because  the  cerebrum  is  made 
more  moist  than  is  proper  and  consequently  with  it  also  the  instruments 
moving  the  tongue  and  the  tongue  itself.  Immoderation  in  the  cerebrum 
also  occurs  in  frenzy,  in  which,  since  the  cerebrum  is  made  warm  and 
dry,  the  imaginative  faculty  can  not  operate  and  move  the  tongue,  as 
it  should. 

Now  the  faculty  is  prevented  from  its  function  in  ecstasy  and  in 
melancholy.  In  the  former  indeed,  because,  called  away  elsewhere  by 
phantasms,  it  by  no  means  governs  the  tongue  as  it  ought.  In  melancholy 
itfis  prevented  by  reason  of  three  causes.  One  is  fear,  which  is  ever  the 
companion  of  melancholy.  Hence  Aristotle5  said  that  those  who  fear 

2  De  usu  partium,  xi,  10. 

3  Bk.  vm,  ch.  xxxvi. 

4  Aphorisms,  vi,  32. 

5  Problemata,  sect,  xi,  probl.  30. 


226  PEDIATRICS  OF  THE  PAST 

stammer;  and  this  is  also  what  Hippocrates6  said,  when  he  wrote  that 
the  melancholy  became  stammerers. 

The  imagination  or  faculty  is  hindered  in  melancholy  for  a  second 
reason,  because  it  is  moved  too  vigorously.  This  proposition  is  handed 
down  by  Aetius7  in  accordance  with  the  opinion  of  RufFus  and  Posido- 
nius.  For  from  excessive  movement  of  the  imagination  it  happens  that 
it  wanders  and  on  account  of  wandering  it  does  not  move  the  to  ngue 
as  it  ought.  And  this  is  what  Hippocrates  said  in  his  Liber  Perceptionum, 
that  often  the  tongue  stammers  on  account  of  the  wandering  of  the  mind. 

The  third  cause  is  a  multitude  of  phantasms  and  images.  For  Aris- 
totle,8 treating  of  the  cause  of  hesitance  of  the  tongue,  among  others 
seems  to  place  a  variety  and  multitude  of  images,  because,  while  the 
faculty  is  pursuing  this  or  that  phantasm,  the  tongue  can  by  no  means 
follow  up  diligently  the  action  of  the  faculty,  and  hence  it  wanders  and 
hesitance  occurs. 

And  these  are  the  kinds  of  causes  which  concern  the  faculty  itself 
regarding  stammering.  Those  which  concern  the  instruments  are  faults 
which  are  either  natural  or  contrary  to  nature,  or,  as  Galen9  said,  they 
happen  either  in  the  very  formation  of  the  instruments  or  after  their 
formation.  But  whatever  these  faults  may  be,  they  are  either  similar 
to  disease  or  instrumental.  Those  similar  to  disease  are  immoderation 
especially  of  coldness  and  humidity,  not  only  of  the  tongue  itself,  but 
especially  of  the  muscles  moving  the  tongue  and  the  larynx.  This  is 
what  Galen10  intended  to  indicate,  when  he  wrote  that  laxvotpoiviav 
occurs  because  of  the  weakness  of  the  muscles  of  the  larynx,  caused  by 
diminution  of  the  heat.  This  is  what  Aristotle11  before  Galen  shows  us, 
where  he  writes  that  stammering  and  hesitance  of  the  tongue  occur  from 
coldness  and  humidity. 

But  concerning  this  opinion  a  doubt  arises,  namely,  whether  stam- 
mering is  caused  by  the  mere  immoderation  of  the  coldness  and  humidity. 
For  Galen12  seems  to  credit  all  stammering  entirely  to  humidity,  while 
on  the  contrary  he  writes  that  it  is  impossible  for  stammering  in  children 
never  to  arise  from  dryness.  This  is  also  what  Aristotle13  seems  to  have 
intended  to  indicate,  when  he  said  that  children  stammer  more  than 
men,  namely,  because  of  humidity.  But  to  the  contrary  is  Hippocrates,14 

6  Epidemics,  II. 

7  Bk.  vi,  ch.  ix. 

8  Problemata,  sect.  xi. 

9  De  Iocis  affectis,  iv,  6. 

10  Epidemics,  I,  ii,  text.  68. 

11  Problemata,  sect,  xi,  probl.  io,  30,  35. 

12  Aphorisms,  vi,  32. 

13  Sect,  xi,  probl.  30. 

14  Epidemics,  vn,  near  beginning. 


HIERONYMUS  MERCURIALIS  227 

where,  telling  a  certain  story  of  sick  persons,  he  says  that  their  tongue 
on  account  of  dryness  was  whitish;  and  from  this  passage  it  is  clearly 
to  be  inferred  that  stammering  also  occurs  from  dryness.  This  is  the 
same  as  Avicenna15  manifestly  writes. 

By  way  of  harmonizing  this  dissension  of  authorities,  it  must  be  said 
that  stammering  is  of  two  kinds:  the  one  natural;  the  other,  accidental. 
The  natural  kind  occurs  for  no  other  cause  than  that  mentioned  by 
Galen,  namely,  humidity.  But  the  unnatural,  that  is,  the  accidental, 
can  also  occur  from  dryness,  and  of  this  Hippocrates  and  Avicenna 
spoke.  Now  the  reason  why  natural  humidity  causes  stammering  and 
why  it  is  that  some  cannot  pronounce  r  or  c  is  that  to  pronounce  these 
letters  it  is  necessary  for  the  tongue  to  be  strongly  impelled  against  the 
teeth  and  against  the  palate,  while  a  tongue  that  is  soft  or  too  moist  or 
weak  on  account  of  the  humidity  of  the  muscles  cannot  be  impelled 
vigorously  enough  against  the  teeth,  and  hence  in  place  of  this  letter 
those  are  pronounced  which,  although  they  are  similar,  have  no  need 
of  so  great  impulsion.  In  other  words,  we  can  say  that  stammering  occurs 
generally  from  humidity,  but  rarely  from  dryness.  This  is  what  not  only 
Avicenna  himself  expressly  seems  to  say,  but  also  Aristotle16  said,  where 
he  stated  that  stammering  occurs  in  children  especially  on  account  of 
the  humidity  and  looseness  of  the  tongue. 

Now  stammering  occurs  when  the  tongue  is  either  longer  than  it 
should  be,  as  Galen17  said  (although  this  rarely  happens),  or  when  it 
becomes  thicker  and  more  swollen;  or  when  the  teeth  are  lacking  or 
are  characterized  by  bad  order;  or  when  the  lips  are  mutilated;  or  when 
the  nostrils  or  windpipe  are  obstructed  by  a  swelling  or  inflammation. 

Of  the  external  causes  of  faulty  speech  especially  is  cold  air.  For 
Aristotle18  said  that  coldness  impedes  speech  from  three  causes.  First, 
because  coldness  condenses.  Secondly,  because  it  weakens  the  native 
heat  and  consequently  the  motor  faculty.  Thirdly,  because  it  binds  the 
tongue  as  it  were.  For  to  accomplish  speech,  the  same  authority19  said, 
it  is  very  necessary  that  the  tongue  be  free  and  unhampered.  So  a  cold 
region  can  prevent  the  people  from  speaking  properly,  and  on  this 
account  also  it  happens  that  in  certain  localities  by  a  certain  hereditary 
affection  as  it  were  among  the  men,  speech  is  faulty. 

Affections  of  the  mind  above  others  are  wont  to  induce  stammering. 
Concerning  fear  it  is  both  clear  from  experience  and  confirmed  by  Aristotle 
and  Galen.  Concerning  anger  similarly,  for  many  may  be  seen,  who, 

16  in,  6,  tract.  3,  ch.  xvi. 

16  De  historia  animalium,  iv,  9. 

17  Aphorisms,  VI. 

18  Problemata,  sect.  xi. 

10  De  partibus  animalium,  11,  17. 


228  PEDIATRICS  OF  THE  PAST 

while  they  are  burning  excessively  from  anger,  sometimes  not  only 
stammer,  but  also  are  forced  to  be  dumb.  The  same  power  is  had  by 
profound  thoughts,  excessive  wakefulness,  immoderate  love,  which, 
since  it  seriously  affects  the  cerebrum  and  all  the  nerves,  consequently 
carries  with  it  impairment  of  speech.  But  especially  does  continual  drunk- 
enness impede  speech,  as  Aristotle20  and  Galen21  have  very  clearly  shown. 
There  are  also  foods,  which  by  a  certain  property  seem  to  interfere  with 
children's  speech.  For  Raby  Moyses22  writes  that  children  must  be 
restrained  from  eating  nuts,  because  they  impair  their  speech. 

But  there  is  no  need  of  signs,  in  order  that  the  faults  of  speech  be 
recognized,  but  to  recognize  the  causes  it  is  necessary  to  use  both  signs 
and  great  industry.  For  those  who  are  made  mute  from  birth  on  account 
of  deafness  are  recognized  both  because  they  are  moved  by  no  noise,  by 
no  sound,  and  because  they  have  no  defect  either  in  the  tongue  or  in 
the  mouth.  And  yet  Aristotle23  writes  that  the  mute  speak  or  give  forth 
a  noise  with  their  nostrils,  because  they  have  a  closed  mouth,  and  that 
they  have  a  closed  mouth,  since  the  tongue  is  of  no  use  to  them.  Now  those 
who  are  made  mute  either  on  account  of  a  wound  inflicted  or  on  account 
of  a  loosening  of  the  muscles  of  the  tongue  are  recognized  by  the  diseases 
themselves  which  have  preceded,  namely,  apoplexy  or  some  illness  of  this 
kind  which  preceded.  Moreover,  those  who  can  scarcely  speak  now  and 
called  noyi\a\oi  by  the  Greeks  and  are  recognized,  since ,  if  their  tongue  is 
inspected,  that  bridle  which  is  commonly  called  philetum  is  very  awkward 
and  unfit.  For,  as  is  held  in  Meletius,  De  natura  bominis,  since  the  tongue 
should,  by  its  own  unimpeded  movement  now  in  this  direction,  now  in 
that,  fashion  letters,  nature  has  decreed  that  it  be  able  to  do  this  freely, 
lest  it  be  too  loose  and  wobbly,  and  has  bound  it  to  the  mouth  by  a 
certain  bridle,  which  holds  it  in  check,  lest  it  slip.  But  if  a  bridle  of  this 
kind  be  larger  than  it  ought  to  be,  so  that  it  binds  down  the  tongue  too 
much,  it  is  prevented  from  being  able,  in  making  the  due  movements 
against  the  palate,  to  articulate  the  voice  as  it  should.  And  where  this 
bridle  is  small,  it  is  recognized,  because  the  tongue  being  elevated  seems 
as  though  bound  to  nothing,  just  as  on  the  contrary,  if  this  bridle  be  too 
large,  it  is  recognized,  because  it  embraces  much  of  the  tongue  and 
tightly  holds  it  from  being  moved. 

Hesitance  of  the  tongue,  or  l<rxvo<puvia,  as  often  as  it  occurs  from 
diminished  heat  of  the  part,  is  recognized  very  clearly  from  the  fact  that, 
whenever  they  speak  quietly  and  slowly,  a  great  impediment  is  always 
apparent,  but,  when  they  speak  with  a  high  voice  and  vigorously,  then 

20  Problemata,  sect.  iii. 

21  Aphorisms,  vi,  32. 

22  Aphorisms,  part.  xx. 

23  Problemata,  sect,  xi,  probl.  2. 


HIERONYMUS  MERCURIALIS  229 

they  have  more  unimpeded  speech,  because  from  the  movement  and 
great  voice  the  muscles  moving  the  tongue  grow  warm  and  therefore  are 
more  easily  moved.  If  stammering  occurs  from  excessive  humidity  of  the 
parts,  it  is  recognized,  since  they  are  somnolent,  of  sluggish  disposition, 
with  scarcely  any  memory,  and  while  they  speak  always  emit  a  quantity 
of  saliva.  If  the  speech  be  faulty  either  on  account  of  lack  of  teeth  or 
mutilated  lips  or  some  disease  of  the  nostrils,  this  is  easily  recognized  by 
its  own  signs. 

The  mute,  who  are  also  deaf,  are  never  cured  and  therefore  among 
the  miracles  which  our  Savior  wrought  was  one  where  He  cured  the 
deaf  mute,  in  Matthew,  xv.  But  if  muteness  or  deprivation  of  speech 
arises  from  excessive  looseness  of  the  muscles  caused  by  abundant 
humidity,  a  fault  of  this  kind  is  cured  not  only  by  the  aid  of  the  doctor, 
but  also  sometimes  nature's  own  accord.  For  it  is  said  that  Maximilian, 
the  son  of  the  Emperor  Frederick  in,  up  to  the  ninth  year  of  his  age 
was  altogether  speechless  and  mute,  but  nevertheless  by  a  favor  of 
nature  not  only  acquired  speech,  but  also  was  most  eloquent.  For  in 
his  case  it  must  be  thought  that  the  fault  had  its  origin  in  abundant 
humidity,  which  by  the  advance  of  age  was  consumed.  So  when  we  read 
that  various  persons  either  because  of  fear  or  anger,  at  the  time  that 
they  were  mute,  have  suddenly  acquired  speech,  it  must  not  be  thought 
that  this  has  been  accomplished  by  any  accident  or  miracle,  but  on  this 
account,  namely,  because  the  impediment  caused  by  humidity  has  been 
removed.  So  natural  stammering  of  the  mouth,  whatever  it  may  be,  is 
difficult  to  cure,  while  that  which  occurs  from  some  adventitious  disease 
is  not  so  difficult  of  cure.  But  as  I  have  said  regarding  deprivation  of 
speech  which  can  be  cured  and  is  cured  by  nature's  own  accord,  so  it 
must  be  thought  regarding  stammering. 

On  this  subject,  before  I  shall  attack  the  cure,  three  problems  arise. 
The  first  of  these  is,  why  was  it  said  by  Hippocrates24  that  stammerers 
are  attacked  by  a  running  of  the  bowels.  Second,  why  has  the  same 
Hippocrates25  said  that  stammerers  are  good,  for  Aristotle  likewise26 
writes  that  the  sign  of  a  moderated  mind  is  serious  and  slow  speech. 
Third,  why  in  those  same  passages  has  Hippocrates  said  that  stammerers 
are  exposed  to  melancholic  diseases,  a  statement  which  is  also  confirmed 
by  Avicenna.27  For  this  seems  almost  beyond  reason,  that  those  who  have 
a  very  moist  cerebrum,  in  which  class  are  stammerers,  can  be  attacked 
by  melancholy,  which  is  a  dry  humor. 

To  the  first  problem  it  must  be  stated  in  reply,  for  no  other  reason 
than  that  interpreted  by  Galen  in  his  comment  on  that  Aphorism, 

24  Aphorisms,  n,  32. 

25  Epidemics,  xxi,  at  the  beginning,  sect,  v  and  vi. 
28  In  his  Physiognomy. 

27  in,  i,  tract.  4,  c.  18. 


230  PEDIATRICS  OF  THE  PAST 

namely,  that  stammerers  necessarily  have  either  a  moist  cerebrum  or  a 
moist  tongue.  If  they  have  a  moist  cerebrum,  the  pituitous  excrements 
precipitated  from  the  head  to  the  belly  and  consequently  into  the 
intestines  cause  the  flowing  of  the  bowels.  And  this  is  also  considered 
as  held  by  Hippocrates.28  Indeed  Avicenna29  said  that  stammerers 
also  for  this  reason  are  often  attacked  by  choleric  suffering.  But  if 
stammerers  are  such  because  of  excessive  humidity  of  the  tongue  since 
the  tongue  has  a  common  covering  with  the  belly,  they  necessarily  have 
a  moist  belly,  while  a  familiar  affection  of  a  moist  belly  is  flowing  of  the 
bowels,  as  Galen  says. 

To  the  second  problem  it  must  be  said  that  stammerers  are  good  on 
this  account,  since  those  who  are  of  bad  character  are  such  because 
they  have  warm  and  dry  spirits;  and,  since  on  account  of  these  their 
minds  are  moved  quickly,  it  happens  that  they  do  not  pay  attention  to 
things  as  it  is  proper,  and  hence  lack  prudence  and  consequently  are 
of  bad  character.  Hence  it  happens  that  it  is  in  warm  and  dry  regions 
that  the  sly  and  evil  are  and  in  these  regions  also  savage  brutes  and  wild 
beasts  are  born.  Now  it  happens  to  the  contrary,  where  the  spirits  are 
moist,  because,  since  they  cannot  be  moved  quickly  and  pay  more 
attention  and  do  not  have  quick  movements,  it  rightfully  happens  that 
they  have  moderated  minds  and  also  good  character. 

More  difficult  than  all,  however,  is  the  third  and  last  problem, 
namely,  why  has  it  been  said  by  Hippocrates  that  stammerers  are  melan- 
cholic and  subject  to  melancholic  diseases.  Now  this  matter  is  rendered 
more  difficult  by  the  authority  of  Galen,  who,30  explaining  that  opinion 
of  Hippocrates  wherein  he  writes  that  if  anyone  suddenly  becomes  of 
incontinent  tongue  he  is  melancholic,  says  that  he  does  not  know  upon 
what  ground  an  incontinent  tongue  indicates  a  melancholic  person; 
and  finally,  as  if  himself  also  having  refuge  in  the  properties  of  things, 
subjoins  that  perhaps  this  is  so,  because,  just  as  a  quartanary  paroxysm 
comes  from  a  melancholic  humor,  so  likewise  an  incontinent  tongue 
comes  from  melancholy. 

Since  Girolamo  Cardan  likewise  saw  that  this  opinion  was  difficult, 
by  a  certain  vanity  of  his  genius  he  said  that  in  Hippocrates  for  incon- 
tinence of  tongue  must  be  understood  wantonness  and  evil-speaking; 
as  if  those  who  have  a  wanton  tongue  and  who  say  obscene  things  are 
melancholic.  But  so  far  is  Hippocrates  from  understanding  incontinence 
of  tongue  as  this  sort  of  thing  that,  if  he  had  said  this,  he  would  have 
been  no  less  vain  than  Cardan.  For  Aristotle,  who  uses  almost  the  same 
words  as  Hippocrates,  says  that  in  children  the  tongue  becomes  incon- 
tinent on  account  of  humidity  and  weakness. 

ffl  In  his  book  De  affectibus  internis. 

29 1,  iv,  doct.  5,  c.  5. 

30  Aphorisms,  sect,  vii,  40. 


HIERONYMUS  MERCURIALIS  231 

Avicenna31  seems  to  have  attributed  this  whole  cause  to  heat  of  the 
heart,  as  if  all  stammerers  who  have  a  very  moist  cerebrum  also  have  a 
very  warm  heart;  and  therefore  where  the  heart  is  very  warm,  from  the 
humidity  into  which  the  heat  continually  goes  melancholic  humors 
arise,  and  consequently  where  humors  of  this  sort  abound  melancholic 
diseases  easily  arise  at  the  same  time.  But  this  opinion  of  Avicenna  can- 
not remove  the  difficulty  of  the  problem.  First,  because  on  no  authority 
of  the  ancients  has  it  been  learned  that  those  who  have  moist  cerebrums 
have  warm  hearts  at  the  same  time;  nay  it  would  seem  that  the  contrary 
should  be  true,  that  the  moist  vastness  of  the  cerebrum  should  weaken 
any  heat  of  the  body.  But  granted  even  that  stammerers  have  warm 
hearts,  it  is  not  necessary  that  the  humor  become  melancholic,  because 
it  can  become  yellow  bile,  as  it  has  often  been  ascertained  that  bilious 
persons  have  warm  hearts. 

Therefore  it  seems  to  me  that  Aristotle  has  explained  this  better 
than  all  others  in  that  passage32  where,  inquiring  why  hesitant  tongues 
are  melancholic,  writes  that  all  melancholic  persons  have  quick  move- 
ments of  the  imagination,  and  therefore  stammerers  likewise,  since  they 
have  quick  movements  of  this  kind,  are  melancholic.  The  same  authority, 
moreover,  says  that  stammerers  and  stutterers  have  quick  movements, 
because,  since  the  instruments  of  the  tongue  itself  are  weak  and  cannot 
exactly  follow  the  concepts  of  the  mind,  it  happens  that  the  movements 
of  the  mind  always  go  ahead  of  the  movements  of  the  tongue  and  hence 
arises  the  hindrance  of  the  tongue.  But  neither  from  these  words  of 
Aristotle  can  it  be  clearly  undertood  why  stammerers  really  are  subject 
to  melancholic  diseases,  unless  we  add  also  the  statement  that  stammer- 
ers, since  they  cannot  speak  as  they  desire  or  as  the  mind  dictates,  as  if 
angry  with  themselves  and  dreading  to  speak  in  the  presence  of  others, 
grieve;  and  this  grief  and  fear  doubtless  cause  a  great  production  of 
melancholy  in  them  and  consequently  subject  them  to  melancholic 
diseases. 

The  cure  of  faulty  speech  is  applied  in  children  only  when  they  have 
already  been  weaned;  for  this  reason,  because  before  that  time  it  cannot 
be  known  whether  their  speech  is  faulty  or  not;  and  all  the  more  so 
because  often  it  also  happens  that  children  up  to  the  sixth  and  seventh 
years  stammer  and  yet  are  cured  of  their  own  accord.  Therefore  when  it 
is  certain  that  the  disease  is  not  to  be  ended  of  its  own  accord,  the  follow- 
ing cure  should  be  promptly  attempted. 

Mutes,  who  are  at  the  same  time  deaf,  should  be  dismissed  altogether. 
But  if  speech  has  been  at  fault  on  account  of  a  looseness  of  the  tongue 
caused  by  excessive  humidity,  the  same  cure  should  be  applied  as  is 


31  in,  i,  tract.  4,  c.  18. 

32  Problemata,  sect,  xxx,  probl.  3. 


232  PEDIATRICS  OF  THE  PAST 

applied  in  stammering;  and  therefore  when  I  shall  treat  of  the  cure  of 
stammering,  at  the  same  time  also  will  be  had  the  cure  of  muteness. 

If  the  child  is  impeded  in  speech  because  of  excessive  binding  of  the 
bridle,  all  cure  lies  in  manual  operation  alone.  Galen  indeed  writes  that 
obstetricians  were  accustomed  with  their  nails  to  cut  away  that  membrane 
which  is  called  the  bridle;  but  whether  it  be  because  of  the  inexperience 
of  our  obstetricians  or  whether  it  be  that  sometimes  this  operation  alone 
does  not  suffice,  it  is  necessary  to  use  another  operation.  Cornelius  Celsus, 
the  expert  surgeon,  proposes33  a  cure  which  Aetius34  also  proposed.  It 
is  an  operation  of  such  a  kind  that  the  tongue  is  elevated  toward  the 
palate,  so  that  it  touches  it,  then  with  a  very  smooth  hook  that  membrane 
is  stretched,  afterwards  it  is  entirely  cut  off  with  a  very  sharp  knife,  yet 
so  that  the  veins  are  in  no  wise  broken.  When  this  has  been  done,  the 
mouth  should  be  washed  out  with  posca,*5  then  sprinkled  with  powder  of 
manna,  of  incense;  then  the  wound  should  be  cared  for,  if  there  be  need, 
just  as  other  wounds.  Cornelius  Celsus  adds  one  thing,  namely,  that 
generally  as  soon  as  this  membrane  has  been  cut  away  speech  is  restored, 
yet  sometimes  is  not  restored;  because  although  what  should  be  done  is 
constant,  yet  what  ought  to  follow  is  not  constant. 

But  often  in  practice  it  happens  that  from  a  vein  broken  in  the 
cutting  a  flow  of  blood  is  feared.  While  this  is  feared,  Avicenna  advises, 
and  very  prudently  so,  that  the  membrane  itself  be  not  cut  off,  but 
perforated  around  its  root  with  a  needle,  and  with  this  very  needle  a 
thread  interwoven,  and  so  tied.  For  this  thread,  if  tightened  daily, 
in  a  short  time  and  agreeably  cuts  off  that  membrane.  And  this  method 
is  very  pleasing.  But  lest  the  membrane  grow  together  again,  once  it  has 
been  cut,  the  rest  of  the  membrane  is  consumed  with  Egyptian  ointment 
or  drying  powders. 

Now  in  curing  all  stammering  diligence  must  be  used  to  see  what 
the  chief  cause  is,  because  if  a  polypus  of  the  nose  causes  it,  all  care  should 
be  directed  toward  curing  that.  If  it  is  caused  by  mutilated  lip,  no  hope 
remains.  If  it  is  caused  by  a  tooth  removed,  this  is  only  a  reason  for  an  ivory 
tooth  to  be  prepared  and  put  in  place  of  the  missing  one  and  bound  to  the 
remaining  teeth.  When  this  tooth  grows  out  again,  it  is  removed,  for  this 
remedy  is  especially  of  service  to  children  as  well  as  also  to  men.  If  this 
fault  is  caused  by  a  fault  of  the  cerebrum  or  of  the  tongue  or  of  the  mus- 
cles, the  fault  arises  either  from  dryness  or  from  excessive  humidity  and 
coldness.  If  from  dryness,  as  happens  in  fevers  and  after  frenzies,  care 
should  be  taken  that  the  tongue  and  the  beginning  of  the  spinal  marrow 
be  moistened  by  every  means.  For  moistening  the  tongue,  the  use  of 

33  Bk.  vii,  ch.  xii. 

34  Bk.  vin,  ch.  xxxii. 

36  [Posca,  an  acidulous  drink  of  vinegar  and  water.] 


HIERONYMUS  MERCURIALIS  233 

woman's  milk  as  a  gargle  is  useful;  it  is  useful  also  often  to  wet  the  tongue 
with  water  of  mallows,  with  which  has  been  mixed  oil  of  sweet  almonds; 
and  if  the  leaves  of  nymphaea  are  boiled  together,  the  greatest  benefit  is 
rendered.  For  the  spine  or  beginning  of  the  spinal  marrow,  liniments 
which  can  soften  those  parts  are  beneficial. 

1^  axungiae  porcinae  aqua  malvae  Iotae,  pin- 

guedinis  gallinae ana  5  i 

olei  amygdalarum  dulcium,  nenufarini ana  5  H 

croci 3}£ 

Mix  and  let  a  liniment  be  made  in  the  mortar. 

Much  more  zeal  should  be  used  when  the  stammering  is  caused  by 
the  humidity  and  coldness  of  the  tongue,  both  because  this  cause  is  of 
more  frequent  occurrence  and  because  to  fight  it  off  more  aids  are 
needed.  And  what  I  shall  say  about  its  cure  should  be  considered  to 
apply  to  mutes  who  are  such  because  of  a  looseness  due  to  excessive 
humidity.  The  chief  purpose  in  this  cure  is  that  the  tongue,  the  cerebrum 
and  the  muscles  moving  the  tongue  be  dried  out  and  warmed;  because 
indeed  the  tongue  and  the  muscles  can  be  dried  out,  especially  if  either 
the  humidity  with  which  they  are  filled  is  dissipated  or  the  same  humid- 
ity is  deflected  to  other  parts  of  the  body,  and  therefore  attention  will 
have  to  be  paid  to  all  these,  in  order  that  the  humidities  be  entirely  dried 
up.  Now  to  accomplish  this  aids  must  be  sought  from  dietetics,  from 
pharmaceutics  and  from  surgery. 

First,  therefore,  when  a  cure  has  been  undertaken,  care  must  be 
taken  that  the  sick  person  to  be  cured  remain  in  warm  and  dry  atmos- 
phere. Perhaps  on  this  score,  when  that  stammerer  in  Herodotus  con- 
sulted the  oracle  by  what  means  he  might  cure  his  stammering,  reply 
was  made  to  him  that  he  go  to  Libya,  a  very  warm  and  very  dry  region. 
He  should  stay  awake  more  than  sleep.  Concerning  the  passions  of  the 
mind,  it  is  clear  that  anger  is  to  be  avoided,  since,  as  I  was  saying, 
it  is  said  that  many  have  fallen  into  stammering  through  anger  alone. 

But  concerning  fear,  it  is  a  very  pretty  question,  whether  the  doctor 
in  curing  stammering  should  be  attached  to  or  avoid  fear.  For  on  the 
one  hand  is  reason,  that  it  should  be  altogether  avoided,  because  there 
is  no  doubt  that  fear  cools.  Therefore  I  have  said  elsewhere  that  those 
who  fear  sometimes  stammer.  But  on  the  other  hand  examples  are  to 
be  found  in  the  historians  wherein  it  is  said  that  by  fear  alone  children 
and  even  men,  although  they  .had  been  previously  mute,  had  acquired 
speech.  For  Pausanias  relates  that  a  certain  mute  Battus,  beholding  a 
lion  in  the  desert,  was  stricken  with  very  great  fear  and  immediately 
acquired  speech.  The  story  is  told  also  of  Atys,  the  son  of  Croesus,  who 
fearing  that  his  father  would  be  killed  by  Cyrus,  as  soon  as  he  beheld 


234  PEDIATRICS  OF  THE  PAST 

the  danger,  acquired  speech.  And  therefore  since  these  events  which 
are  related  seem  to  have  occurred  in  the  natural  course  without  any 
miracle,  it  seems  possible  also  sometimes  that  muteness  or  stammering 
may  be  cured  by  fear  aroused  by  the  doctor. 

A  solution  of  this  problem  not  proposed  by  anyone  seems  to  me  to 
be  as  follows.  Fear  is  of  two  kinds:  one,  called  by  the  Greeks  <rya> via, 
by  us,  trepidation;  the  other,  that  which  is  properly  called  fear  by  us, 
by  the  Greeks  <po@os.  Trepidation  exists  when  men  who  are  about 
to  attack  some  great  thing  fear;  and  this  kind  of  fear  is  greater  than 
fear  so-called.  In  trepidation,  as  is  held  in  Aristotle,36  there  is  as  it  were  a 
certain  species  of  shame  (pudor);  whence,  just  as  in  shame  the  parts 
around  the  breast  and  face  grow  warm,  as  is  discerned  from  the  redness, 
so,  says  he,  to  those  hi  trepidation  comes  a  heat  around  the  breast  and 
around  the  face,  and  on  account  of  this  heat  the  voice  becomes  heavy. 
Otherwise,  however,  in  those  in  fear,  because  in  them  the  parts  of  the 
breast  and  the  upper  parts  are  cooled,  while  heat  seeks  the  lower  parts. 
Whence  Aristotle37  said  that  in  those  in  fear  the  semen,  urine  and  faeces 
flow  of  their  own  accord,  because  the  heat  borne  down  to  those  lower 
parts  excites  those  excretions. 

Therefore  with  this  solution  established,  it  is  easy  to  untie  the 
knot,  namely,  that  simple  fear  not  only  does  not  aid  stammering,  but 
rather  aggravates  it,  because  thereby  the  tongue  and  breast  and  upper 
parts  are  cooled,  as  is  discernible  from  the  pallor.  But  trepidation  may 
be  of  great  assistance  to  both  stammering  and  muteness,  because  with 
the  breast  and  upper  parts  warmed  it  is  not  to  be  doubted  that  there  may 
also  be  removed  that  excessive  humidity  and  at  the  same  time  the 
weakness  which  arises  from  poverty  of  native  heat,  and  therefore  it 
may  be  entirely  useful  to  induce  this  trepidation  in  children. 

The  body  should  be  exercised,  as  much  as  possible,  but  especially 
should  the  voice  be  exercised,  and  if  there  is  anything  which  can  benefit 
stammerers  and  stutterers  it  is  continual  deep  and  clear  speaking. 
There  is  an  example  of  this  point  in  the  Great  Demosthenes,  who,  as 
Plutarch  relates  in  his  life  and  in  the  book  De  oratoribus,  overcame 
stammering  by  the  mere  exercise  of  his  voice  and  oratory.  For  he  gave 
10,000  drachmae  to  the  actor  Neoptolemus,  who  taught  him  how  to 
utter  many  lines  with  a  single  breath,  namely,  that  climbing  and  running 
with  pebbles  inserted  in  his  mouth  he  should  continually  utter  lines. 

They  should  refrain  from  love,  if  they  are  men,  while  children  should 
abstain  from  the  use  of  baths.  Therefore  mothers,  who  are  wont  to 
frequently  bathe  the  head  of  stammering  children,  do  wrong,  since 
they  increase  the  humidity  and  the  cause  of  this  fault.  Care  should  be 

36  Sect,  xi,  probl.  32  and  53. 
'7  Sect,  viii,  probl.  4. 


HIERONYMUS  MERCURIALIS  235 

taken  that  the  bowels  flow  daily,  if  not  naturally,  at  least  artificially. 
They  should  abstain  from  wine  or  use  it  weak  and  in  small  quantities. 
They  should  use  as  their  food  aromatic,  salty,  sharp  edibles,  while  they 
abstain  from  the  use  of  pastries,  nuts,  fish;  and  to  speak  in  a  word, 
the  entire  principle  of  living  should  be  to  dry  out  and  make  warm. 
When  this  principle  of  living  has  been  established,  the  child  should 
be  purged. 

For  first,  if  the  bowels  have  not  flowed  of  their  own  accord,  the  following 
little  potion  should  be  dissolved: 

1^  foliorum  sal  viae,  betonicae ana  Mss 

coriandri 3i 

foliorum  sennae 3ii 

Let  a  decoction  be  made  according  to  the  profession,  then 
1^  dictae  decoctionis 3  ii/^ 

mellis  rosati  solutivi gii  or  ii^ 

Mix;  let  a  potion  be  made. 

Then  the  body  should  be  prepared  for  the  purging: 

]$  foliorum  salviae,  origani,  staechados ana  ttj^ 

Let  a  decoction  be  made  according  to  the  profession,  then 

1^  dictae  decoctionis 5  iii 

oximellis  simplicis 5  ii 

syrupi  de  betonica,  de  staechade ana  5  M 

Mix;  let  a  potion  be  made. 

After  the  body  has  been  prepared,  it  should  be  purged,  and  in  this 
purging,  if  it  has  been  permitted  to  use  pills,  they  should  be  preferred 
to  other  medicaments. 

1$  pillularum  de  hiera  cum  agarico 3i^ 

pillularum  cochiarum 3i 

Mix;  let  pills  be  made  to  the  number  of  5. 

In  order  that  these  may  be  swallowed  more  easily  by  children,  they  may 
be  concealed  in  a  little  cake  or  in  some  jam;  but  if  they  have  refused 
the  pills,  the  following  potion  will  be  given : 

IJ  agaraci  trociscati 3ii 

gariophilorum gr.  iv 

Let  them  be  infused  in  water  of  staechados  or  betonica, 
then  having  been  pressed  out,  add  3  drams  of  diacatholicon,  1 
ounce  of  soluble  honey  of  roses  with  a  cordial  decoction.  Let 
a  potion  be  made. 


236  PEDIATRICS  OF  THE  PAST 

When  the  body  has  been  purged,  care  should  be  taken  that  those 
parts  together  with  the  cerebrum  be  still  more  dried  up;  and  to  do  this, 
medicaments  which  are  drawn  in  the  nostrils  and  sneezings  are  beneficial. 

1$  succi  radicum  bethae 5  J£ 

succi  betonicae 5  i 

aquae  coriandrorum lb.  J^ 

Let  them  be  mixed  and  drawn  in  the  nostrils. 

When  the  child's  body  has  been  purged  for  a  little  while,  care  should 
be  taken  that  the  head  and  the  tongue  be  continually  dried  up.  The 
head  is  continually  dried  up  by  a  cautery  made  of  nucha;  scarcely  any 
remedy  is  found  more  effective  in  this  category  than  this  remedy. 
In  like  manner  for  drying  up  the  head,  vesicatories  applied  behind  the 
ears  and  kept  there  for  a  long  time  are  very  potent.  For  drying  up  the 
tongue  it  is  of  advantage  if  that  is  rubbed  now  with  honey,  now  with 
salt,  and  very  often  with  saliva.  How  very  useful  this  is  for  doing 
away  with  stammering  is  attested  by  usage. 

And  here  is  the  end  of  those  affections  which  concern  the  motor 
faculty. 


FELIX  PLATTER 

[1536-16 1 4] 

THOMAS  PLATTER,  the  father  of  Felix  Platter,  was  a 
learned  man,  a  scholar  of  distinction,  but  a  poor  business  man, 
wrecking  what  little  fortune  he  had  in  a  printing  establish- 
ment in  Basel.  His  son,  Felix  was  born  in  October,  1536,  and  was 
accorded  a  liberal  education.  Felix  married  Madeleine  Jeckelmann, 
but  had  no  children,  which  doubtless  influenced  his  father  to 
marry  a  second  time  when  he  was  left  a  widower  at  the  age  of 
seventy-three,  in  order  to  perpetuate  the  family.  By  this  second 
marriage  there  were  six  children.  The  eldest,  Thomas  was  edu- 
cated by  Felix  and  carrying  out  the  literary  traditions  of  the 
family,  he  left  an  account  of  his  travels  which  have  been  recently 
(1892)  printed  in  a  sumptuous  but  very  limited  edition  by  the 
"Societe  des  Bibliophiles  de  Montpellier,"  under  the  title  of 
"Felix  et  Thomas  Platter  a  Montpellier.  Notes  de  voyage  de  deux 
etudiants  balois."  Thomas,  the  father,  when  he  was  seventy-six 
years  old,  wrote  a  "  Selbstbiographie  "  for  his  son  Felix,  completing 
it  in  fourteen  days,  full  proof  of  his  vigor,  had  any  been  needed. 
Felix,  in  addition  to  other  writings,  followed  his  father's  example 
and  we  also  have  his  expense  accounts  and  other  items  which 
help  to  make  more  complete  our  information  concerning  the  period 
in  which  he  lived. 

In  1552  Felix  was  sent  to  Montpellier,  where  he  studied  medi- 
cine with  such  assiduity  that  he  received  his  doctorate  September 
20,  1557.  Of  his  ambitions  and  studies  we  may  quote  his  own 
words  in  the  very  beginning  of  the  account  of  his  wanderings. 

From  my  infancy,  my  dream  was  to  study  medicine  and  become 
a  doctor.  My  father  deserving  this  as  much  as  I,  because  he  had  com- 
menced the  same  studies.  He  spoke  often  of  the  consideration  which 
the  doctors  enjoyed,  and  while  I  was  yet  a  small  child  he  made  me  admire 
them  as  they  passed  in  the  street  on  horseback.  Considering  that  I  had 
reached  the  age  of  fifteen,  and  that  I  was  an  only  son,  he  resolved,  to 
make  me  arrive  at  the  doctorate  the  more  quickly  and  to  find  in  me 

237 


238  PEDIATRICS  OF  THE  PAST 

the  sooner  a  support  for  himself  and  his  family,  to  send  me  to  Mont- 
pellier  where  medicine  flourished. 

The  "Voyage"  makes  interesting  reading,  fresh  and  naive, 
breathing  the  air  of  youth,  albeit  a  modest  one.  At  Sernhac, 
where  he  dined,  he  says:  "The  daughter  of  the  hotel  keeper 
wished  to  kiss  me;  but  I  defended  myself,  which  made  her  laugh 
much,  for  it  is  the  custom  in  this  country  to  wish  the  welcome 
by  a  kiss." 

At  Montpellier  he  chose  pro  patre  Doctor  Antoine  Saporta, 
who,  in  153 1  together  with  Rabelais  and  several  other  bachelors, 
gave  a  representation,  with  all  scholastic  solemnity,  of  the  "Morale 
corne  die  de  celuy  qui  avoit  espouse  une  femme  mute."1  One  would 
like  to  linger  longer  over  this  little  work  which  deserves  an 
English  translation  and  reprinting. 

After  traveling  about  France  and  part  of  Germany,  Felix 
returned  to  Basel,  rich  in  experience  and  ready  for  the  honors 
which  awaited  him.  He  was  archiatre  and  professor  of  medicine, 
both  of  which  positions  he  filled  for  fifty-four  years.  His  success, 
both  as  a  teacher  and  a  practitioner,  was  enormous.  Students 
from  all  over  Europe  crowded  his  lecture  room  and  he  was  in  great 
demand  for  consultations.  He  resisted  all  offers  of  the  wealthy 
to  leave  his  native  city  where  he  had  become  endeared  to  his 
fellow  citizens.  He  was  not  like  Sydenham  when  the  plagues 
of  1564  and  1 610  ravished  that  part  of  Switzerland;  Platter  stuck 
to  his  guns  and  rendered  wonderful  service. 

He  founded  a  botanical  garden  and  as  he  was  childless,  he 
left  it  to  his  students.  His  collection  of  objects  of  natural  history 
was  remarkable. 

Platter  wrote  much.  There  is  no  need  to  list  his  writings 
here;  among  the  best  is  a  work  on  anatomy.  This  work,  "De 
corporis  humani  structura  et  usu  Iibri  in,"  Basel,  1583,  is  a  folio 
which  was  reprinted  in  1603.  It  was  illustrated  with  plates  taken 
from  Vesalius  and  Coiter,  and  sections  on  the  eye  and  ear  from 
his  own  cuts.  He  also  wrote  a  book  on  the  female  genitalia  and  a 
work  on  practice  in  three  volumes,  which  has  been  reprinted 
many  times.  Some  fragments  have  come  down  in  his  own  hand- 
writing, for  example:  The  closing  of  a  poem  to  Burgermeister  von 
Brunn  is  as  follows: 

1  Pantagruel  in,  34.    This  furnished  the  material  for  Anatole  France's  one-act 
farce,  "La  comedie  de  celui  qui  epousa  une  femme  muette." 


>xxxi 


Felix  Plattei 
[1536-1614] 


FELIX  PLATTER  239 

Hiemft  verlich  uns  Gott  gesundheft 

Und  dass  mir  [  =  wfr]  haben  Iang  vfel  Freundt 

Das  Wunchet  giinstiger  Herr  gvatter 

Uns  beiden  Doctor  Felix  Platter. 

Platter  died  July  28,  161 4,  respected,  beloved,  honored.  To 
pediatrics,  we  know  he  made  one  contribution  of  great  value: 
the  description  of  thymus  death.  Like  many  first  descriptions  of 
disease  it  is  contained  in  a  few  words. 

Suffocatio  a  struma  interna  abscondita,  circa  jugulum.  Filius  Marci 
Peresii,  quinque  menses  natus,  bene  habitus,  nullo  precedente  alio 
afFectu,  subito  cum  stridore  et  respirationis  difficultate  e  medio  sublatus 
est;  quo  genete  mortis  prius  quoque  cum  duos  amisisset  filive,  causam 
scire  cupiens,  ipso  rogante,  pectus  aperuimus,  et  in  regione  juguli, 
glandulam  illius  Iocii  in  struman  quondam,  magnam,  unciam  unam  cum 
semisse  pendentem,  spongiosam,  venisque  refertain,  et  quae  beneficio 
membranarum  duntaxat,  vasis  maxomis  illis  juxta  jugulum  ascendenti- 
bus,  adhaerebat,  excrevisse,  deprehendimus,  carniformi  quadam  materia 
et  sanguine  oppleta,  quo  subito  irruente  strumamque  illam  delatante, 
adeo  ut  vasa  illius  loci  premeret,  suffocatum  fuisse  infantum 
judicavimus.2 

[Suffocation  from  a  hidden  internal  struma,  about  the  throat.  The 
son  of  Marcus  Peresius,  five  months  of  age,  well  nourished,  with  no 
previous  illness,  suddenly  died  from  difficult  breathing,  suffocation. 
As  the  father  had  previously  lost  two  sons  from  the  same  malady  and 
being  desirous  of  knowing  the  cause,  we  opened  the  chest,  at  his  request 
We  found  the  gland  in  the  region  of  the  throat  as  a  large  protruding 
tumor,  one  ounce  in  weight,  spongy,  fleshy  and  pendent,  replete  with 
veins,  adhering  by  membranes  to  the  largest  ascending  vessels  adjacent 
to  the  throat;  these  being  filled  with  blood  and  flowing  into  the  struma, 
dilated  it  to  such  an  extent  that  it  compressed  the  blood  vessels  in  the 
locality;  in  which  manner  I  concluded  the  child  was  thus  suffocated.] 

2  Plater,  Felix.  Observationum  in  hominis  affectibus  plerisque,  .  .  .  Iibri  tres. 
Basileae,  1614,  172. 


B 


GUILLAUME  DE  BAILLOU  [BALLONIUS] 

[1538-1616] 

AILLOU  or  Ballonius,  whom  Crookshank  calls  the  first  epi- 
demiologist of  modern  times,  was  born  in  Paris  in  1538,  the 
son  of  Nicolas,  a  celebrated  mathematician  and  architect. 
He  studied  Latin  and  Greek  and  later  philosophy  at  the  University 
of  Paris  and  then  turned  his  attention  to  medicine  in  the  medical 
school  of  the  same  city.  In  1568  he  received  his  bachelor's  degree 
and  was  made  doctor  in  1570.  For  forty-six  years  thereafter  he 
practiced  his  profession  and  died  in  161 6,  at  the  age  of  seventy- 
eight.  He  naturally  followed  in  the  footsteps  of  his  teachers, 
among  whom  were  counted  Daret  and  Fernel.  As  a  professor  he 
attained  considerable  prominence,  and  the  fact  that  he  earned  the 
name  oifleau  des  bacbeliers  makes  it  certain  that  he  struck  terror  to 
the  hearts  of  the  candidates.  In  1580  he  was  made  doyen  of  the 
Faculty  of  Paris  and  attained  considerable  prominence  in  a 
number  of  ways.  When  they  opened  the  gates  of  the  city  to  the 
Bearnais,  Baillou  was  chosen  by  his  compatriots  of  the  faculty  to 
present  the  keys  of  the  city  to  Henry  iv  who  subsequently 
appointed  him  physician  to  the  Dauphin  but  this  honor  he  refused 
that  he  might  remain  physician  to  "ses  bourgeois  de  Paris." 

Apparently  nothing  of  his  was  printed  during  his  lifetime 
but  he  bequeathed  his  manuscripts  to  two  physicians  connected 
with  his  family,  Jacques  Thevart  and  Simon  Ie  Letier. 

By  far  his  most  important  contribution  is  his  two  volume 
work,  "Epidemiorum  et  Ephemeridum  Iibri'duo."  These  appeared 
in  1639  and  again  in  1640.  Sets  of  the  "Consilia"  appeared  volume 
by  volume  bearing  the  dates  Vol  1,  1635;  Vol.  11,  1636  and  Vol.  in, 
1 749.  Other  dates  are  given  for  these  volumes,  evidently  reprints. 
"Definitionum  medicarum  liber,"  1639;  "  Commentarius  in 
Iibellum  Theophrasti  de  vertigine,"  1640;  "De  convulsionibus 
Iibellus,"  1640;  "Liber  de  rheumatismo  et  pleuritide  dorsali," 
1642;  "De  virginum  et  mulierum  morbis  liber,"  1643;  "Opuscula 
medica  de  arthritide,  de  calculo  et  urinarum  hypostasi,"  1643; 

240 


Guillaume  de  Baillou. 


242  PEDIATRICS  OF  THE  PAST 

Adversaria  medicinalia.  All  of  these  works  were  collected  in  one 
edition,  "Opera  omnia/'  by  Jacques  Thevart,  Paris,  1635, 
1640,  1643,  T^49  and  Venice,  1734,  1735,  1736.  These  have 
prefaces  and  a  fine  portrait.  Tronchin  reprinted  these  in  Geneva  in 
1 762  with  a  prefatory  biography  and  study.  A  satisfactory  French 
translation  of  the  "Epidemics  and  Ephemerides,,  was  made  by 
Prosper  Yvaren  and  published  in  1858.  It  includes  an  account 
of  the  life  and  works  of  Baillou. 

The  days  in  which  Baillou  lived  and  wrote  medicine  were 
still  under  the  baleful  influence  of  Galen  and  the  Arabians. 
Astrology  played  a  strong  part  and  even  as  clear  an  observer 
and  thinker  as  Baillou  was  influenced  by  it.  But  the  fact  remains 
that  he  is  a  worthy  successor  and  follower  of  Hippocrates, 
whose  methods  of  observation  and  description  he  revived  along 
with  the  doctrine  of  the  epidemic  constitution,  writing  about  it 
much  in  the  same  vein  as  Hippocrates  and  Sydenham.  These 
three  authors,  although  dealing  with  different  subject  matter, 
write  strangely  alike.  The  influence  of  season,  climate,  and  the 
nature  of  the  epidemic  diseases  are  set  forth  clearly.  Like  Syden- 
ham he  had  personal  experience  with  the  plague  and  brought 
down  upon  his  head  the  wrath  of  the  charlatans  by  his  wise  council. 
Most  important  of  all  is  his  description  of  whooping-cough,  1578, 
and  the  epidemic  from  which  this  disease  spread  over  the  entire 
civilized  world,  making  its  appearance  in  Australia  within  the 
memory  of  those  still  living.  His  short  description  is  well  worth 
reading.  B&illou  was  a  remarkable  character  and  deserves  to  be 
rescued  from  the  comparative  oblivion  into  which  he  has  fallen. 

SUMMER  CONSTITUTION 

Anno  Domini  1578 

We  have  already  previously  spoken  of  the  beginning  of  summer.  At 
the  end  of  summer  almost  the  same  diseases  flourished  as  before.  The 
summer  was  glowing  and  burning  hot.  Boys  four  months  old,  ten  months 
old  and  a  little  older  were  attacked  by  fevers,  which  carried  countless 
off.  Especially  that  common  cough,  which  is  generally  called  quinta  or 
quintana  and  which  we  have  mentioned  before.  Its  symptoms  are 
serious.  The  lung  is  so  irritated  that,  in  its  attempt  by  every  effort  to 
cast  forth  the  cause  of  the  trouble,  it  can  neither  admit  breath  nor  easily 
give  it  forth  again.  The  sick  person  seems  to  swell  up  and  as  if  about  to 
strangle  holds  his  breath  clinging  in  the  midst  of  his  jaws. 


GVLIELMI 

BALLONII 

MEDICI   PARISIENSIS 

CELEBERRIMI, 

EPIDEMIORVM 

ET 

EPHEMERIDVM 

LIBRI    DVO, 

Studio  &opet* .  M.  Iacobi  Thevart   Mcdid 
Panficnfis,  digeffi,  Scholiis  aliquot  ffiuftiati, 
&  in  luccm  primum  editi. 


PARISIIS, 

Aj-d    I  A  C  O  B  V  MOV  ESN  EL,  vu  Iacob«,  SAbm 

M.  DC  XL. 

CrjM    PRiriLEGlO    REGIS. 

Title  page  of  Ballonius. 


244  PEDIATRICS  OF  THE  PAST 

Why  it  is  commonly  called  quinta,  is  not  without  doubt.  Some  think 
the  word  is  a  manufactured  one  through  onomatopoiea,  from  the  sound 
and  the  noise  which  those  so  coughing  emit.  Some  do  not  seek  its  source 
hence,  but  think  that  the  cough  is  called  quintana  in  Latin  because  it 
recurs  at  fixed  hours — a  fact  which  experience  proves  to  be  true.  For 
they  are  free  from  this  annoyance  of  coughing  sometimes  for  the  space 
of  four  or  five  hours,  then  the  paroxysm  of  coughing  returns,  sometimes 
so  annoying  that  the  blood  gushes  out  through  the  nostrils  and  the 
mouth  by  the  violence.  Very  frequently  the  belly  happens  to  be  upset. 
I  have  not  yet  read  any  author  who  writes  about  this  cough. 

And  they  doubt  whether  it  is  from  the  head  or  from  the  body  of  the 
lung  itself  or  from  another  source  that  the  serum  or  ichor  or  whey  or 
bestial  distillation  is  wont  to  flow.  It  seems  to  be  from  the  lung  itself. 
For  we  have  seen  many  so  coughing,  by  whom  after  a  fruitless  attempt 
semiputrid  matter  has  been  ejected  in  an  unbelievable  quantity,  so 
that  it  is  probable  that  this  matter  resident  and  collected  there  is  the 
cause  of  that  cough.  To  others  it  seems  to  be  from  the  head  itself,  as  if 
liquefied  by  a  sort  of  "melting,"  as  Hippocrates  says. 

What,  if  from  another  source?  For  there  are  two  passages  worth 
recalling  in  Galen  and  Hippocrates,  from  which  a  demonstration  of  these 
points  can  be  elicited.  Galen,1  assigning  the  causes  of  a  dry  cough, 
decided  that  the  first  cause  was  an  irritation  of  the  throat  and  jaws; 
the  second,  an  irregularity  of  the  instruments  which  serve  respiration; 
the  third,  a  density  of  humor;  the  fourth,  a  thinness  of  humor.  There- 
upon, he  wrote  about  the  thin  humor  as  follows: 

Now  a  thin  humor  slipping  down  through  the  throat  and  rough  artery 
into  the  lung  <t>6dvei  yliaBai  that  is,  anticipates  being  poured  and 
divided,  or  is  poured  forth  and  dispersed  (for  the  interpreters  negligently 
pass  over  the  elegant  word  <£0am)  before  it  is  shut  off  by  the  breath 
which  has  been  aroused  by  the  cough.  This  happened  to  the  Thasians, 
the  head  being  filled  because  of  their  southern  situation  and  thus  trans- 
mitting the  distillation  to  all  regions  of  the  throat. 

And  in  the  comment  on  point  17  of  the  same  book  he  wrote: 

These  distillations  of  the  head  first  render  men  hoarse  and  choked  up- 
nor  do  they  stop  here,  [for]  they  usually  produce  another  species  of  wast; 
ing  away.  For  its  species  are  two :  one  is  from  flowings  from  the  head,  the 
other  from  affections  of  the  lung  itself,  especially  after  the  expectoration 
of  blood,  chiefly  when  the  organ  has  been  ruptured,  but  frequently  when 
the  lung  has  been  filled  from  another  cause  from  other  parts  and  not 
from  the  head,  as  if  the  flow  pedfia)  were  from  a  source  other  than 
the  head. 

1  Epidemia,  bk.  1,  sect,  i,  comment  on  point  12. 


GUILLAUME  DE  BAILLOU  245 

The  passage,  in  my  opinion,  has  been  badly  rendered  in  Latin: 
7ro\XdKis  d£,  Kotl  pevfiaTiadevTos  tov  irvevjAOvos  5ta  tivcl  aWrjv  alriav  cac 
fiopLwv  frepuv  ovk  tKT&v  ttjs  Ke<f>a\rjs.  I  think  that  pevnaTL^ecrdou  can  be 
interpreted  as  not  to  be  affected  by  distillation,  but  to  be  irrigated  and 
filled  by  means  of  a  sort  of  plundering  by  the  internal  parts  and  a  sort 
of  viroTTJ&s,  that  is,  liquefying  of  the  parts  adjacent  the  lung  itself  or 
even  of  its  own  excrement  which  can  flow  and  be  liquefied.  In  agree- 
ment with  this  the  same  Hippocrates2  wrote: 

Erysipelas  occurs  in  the  lung,  when  it  has  been  dried  out  too  much 
by  heat,  fevers,  labor  and  intemperance.  For  then  it  draws  much  blood 
to  itself,  especially  from  the  large  veins.  The  latter  are  adjacent  to  it  and 
rest  upon  it;  it  causes  [the  blood  to  become]  very  thin  and  weak.  When  it 
has  drawn  [the  blood),  there  arises  therefrom  a  sharp  fever,  a  dry  cough, 
a  filling  up  in  the  breast,  a  sharp  pain  in  the  anterior  and  posterior 
parts,  especially  around  the  spine,  when  the  large  veins  have  become  too 
warm.  They  vomit  blood  sometimes  red,  sometimes  livid.  They  vomit 
phlegm  and  bile  and  are  rendered  breathless. 

In  the  same  place  he  explains  also  the  nature  of  that  most  annoying 
cough,  which  is  called  quinta.  And  the  cause  of  the  dry  cough  is  not  from 
the  head,  as  many  think,  but  sometimes  from  the  lung  itself,  sometimes 
from  adjacent  parts.  That  it  is  from  the  lung  itself  is  shown  by  the 
enormous  quantity  of  putrid  and  half-pus  phlegm  which  is  coughed  up. 
For  if  only  a  bestial  distillation  were  the  cause  of  that  most  annoying 
cough,  which  is  commonly  called  quinta,  that  incredible  quantity  of 
matter  would  not  be  expelled. 

And  yet  I  do  not  deny  that  some  irritating  substance  flows  down  from 
the  head.  For  what's  to  prevent  the  matter  collected  in  the  lung  from 
behaving  in  the  same  manner  as  the  matter  which  is  in  the  belly?  But 
that  which  is  in  the  belly,  accordingly  as  it  is  moved  at  times,  so  it  pro- 
duces gripings  and  prickings  of  the  belly,  dysentery,  diarrhoea,  slight 
ulcerations.  So  likewise  it  causes  irritation  in  the  lung,  pricks  as  it  is 
moved,  and  renders  men  choked  up,  excites  genuine  coughs  and  the 
desire  to  cough  in  vain.  Wherefore  they  err  who  refer  the  cause  of  the 
cough  to  the  head. 

Rather  to  be  referred  to  the  head  is  the  fact  that,  when  the  distilla- 
tion into  the  lung  is  produced  in  a  sleeping  person,  by  entailing  some 
delay  it  acquires  greater  sharpness.  Then  in  the  same  manner  as  sneezing 
is  excited  in  the  head,  that  matter  in  the  lung  is  set  into  commotion, 
moved  and  stirred  up  violently,  whence  the  stimulated  power  of  the  part 
brings  on  that  cough.  But  the  fact  that  some  pevnarurnds  (flowing) 
into  the  lung  is  stimulated  from  a  source  other  than  the  head  is  shown 
by,  the    enormous  quantity  of  matter  which  is  excreted  in   [?].   For 

2  De  mofbis,  bk.  I. 


246  PEDIATRICS  OF  THE  PAST 

scarcely  will  any  one  believe — for  it  is  incredible — that  the  great  quantity 
of  matter  which  is  expelled  flows  from  the  head  and  kuTrvn  drjvcu  so  quickly, 
but  it  flows  from  other  parts  to  the  parts  of  the  thorax. 

Moreover,  incredible  to  say,  of  whatever  kind  and  degree  the  fevers 
have  been  which  attacked  those  who  have  been  rent  asunder  by  that 
cough  commonly  called  quinta,  they  have  been  serious,  violent,  inordi- 
nate and  annoying.  And  although  the  belly  flows,  they  are  scarcely  miti- 
gated, indeed  they  lead  the  sick  to  a  certain  thinness  and  wasting  away. 
And  it  is  remarkable  that  many  boys  have  been  affected  by  those  bestial 
distillations  have  been  killed  by  them  and  have  expelled,  a  little  before 
death  or  afterward,  a  humor  terrible  to  be  seen,  as  if  there  had  been  an 
abscess  in  the  head.  Some  have  died  with  the  greatest  difficulty  of  breath- 
ing and  that  terrible  and  irremediable. 

Some  one  may  ask  whether  the  veins  of  the  lung  are  a  focus 
and  receptacle  for  those  continual  vital  fevers?  Possibly,  if  Galen3  is  to 
be  believed. 

Moreover  one  point  must  be  noted,  which  we  have  observed  in 
diseases  of  this  kind,  namely,  by  the  continual  fever  and  annoying  cough 
which  is  called  quinta  the  body  begins  to  swell  and  then  grows  very 
thin.  Now  that  the  body  begins  to  swell  and  is  rendered  more  colored  in 
these  liquefactions  and  fusions  of  phlegm,  is  the  teaching  of  Hippoc- 
rates4 who  also  shows  why  this  happens.  Likewise  that  the  thinning 
out  occurs  afterwards  is  the  teaching  of  the  same  Galen,5  where  he 
explains  why  the  Thasians  by  coughing  and  a  sharp,  bestial  and  malig- 
nant catarrh  were  reduced  to  extreme  thinness.  The  passage  should  be 
well  noted  and  carefully  read.  And  yet  tumor  and  raising  or  puffing  out 
of  the  skin  can  precede  the  thinning  out,  because  the  looseness  of  the  skin 
precedes  its  thinning  and  contraction  according  to  Hippocrates. 

3  Epidemia,  bk.  i,  sect,  ii,  comment  on  point  73. 

4  De  morbis,  bk.  11. 

6  Epidemia,  bk.  1,  sect,  i,  comment  on  point  28. 


SIMON  DE  VALLEMBERT 

[about  1565] 

OF  this  worthy  we  know  next  to  nothing  except  that  he  was 
born  in  the  sixteenth  century  at  Avallon  in  Bourgoyne.  In 
1558  he  was  physician  to  Marguerite  of  France,  duchesse  de 
Savoie  et  de  Berri  and  in  1565  held  a  similar  post  with  the  due 
d'Orleans.  Besides  his  pediatric  treatise  he  wrote  two  other  medical 
works:  "Traite  de  la  conduite  des  chirurgians,"  Paris,  1558,  and 
Medicamentorum  simplicium  cognoscendorum  methodus  Turoni- 
bus,"  1 56 1.  His  book  on  children,  called  "Cinq  Iivres  de  la  maniere 
de  nourrir  et  gouverner  Ies  enfans  des  Ieur  naissance,"  appeared  at 
Poictiers  in  1565  from  the  press  of  Marnesz  and  Bouchetz  freres. 
It  is  a  single  volume  made  up  of  five  books.  On  the  title  page  we 
are  told  that  the  author  was  physician  to  Madame  la  Duchesse  de 
Savoye  et  de  Berry  and  lately  to  Monseigneur  Ie  Due  d'Orleans. 
The  book  is  dedicated  to  the  Queen,  mother  of  the  King.  It  com- 
prises some  379  pages  measuring  about  six  by  nine  inches,  but  in 
pleasantly  large  type.  The  author  states  that  a  sort  of  anthology 
had  been  made  of  the  authors  writing  in  Latin  by  Miron,  physician 
to  Louis  xii,  but  Vallembert  claims  to  be  the  first  to  treat  of  the 
subject  in  the  French  language. 

The  five  books  treat  respectively:  how  to  choose  a  nurse; 
instructions  to  the  midwife  and  the  nurse  in  the  management 
of  the  newly  born  infant;  how  to  nourish  and  manage  the  infant 
before  weaning;  the  same  after  weaning;  and  finally,  how  to  cure 
the  diseases  of  children. 

The  first  book  gives  in  detail  much  that  is  taught  today,  a 
frank  piece  of  writing  with  little  nonsense  in  it.  Of  course,  he  gives 
the  nail  test  of  Soranus  without  saying  where  it  came  from. 
When  he  comes  to  the  regime  for  the  nurse  to  change  the  milk  if 
too  rich  or  too  poor,  he  gives  the  usual  nonsense  largely  copied 
from  his  predecessors,  as  is  much  of  the  second  book.  His  direc- 
tions for  the  management  and  care  of  nursing  infants  is  meticulous 
in  the  extreme,  for  example  in  bathing  he  gives  over  six  pages, 
nearly  a  page  how  to  rub  an  infant's  head  and  comb  its  hair. 

247 


248  PEDIATRICS  OF  THE  PAST 

He  recommends  bathing  daily  until  the  child  is  able  to  move  about, 
then  less  often,  and  he  agrees  with  les  anciens  Medecins  in  their 
opinion  that  bathing  should  be  continued  until  the  seventh  year! 
He  gives  directions  for  weaning  and  for  feeding  the  child  after 
weaning  with  instructions  for  preparing  its  food.  His  opinions  on 
the  subject  of  giving  wine  to  children  would  make  a  prohibitionist 
weep.  The  last  half  of  the  volume  is  devoted  to  the  cure  of  sick 
infants.  The  first  part  deals  with  things  in  general;  what  to  do  for 
the  sick  child,  what  diseases  it  is  liable  to  have  and  what  medicines 
and  remedial  measures  to  use.  He  then  considers  fevers  of  various 
kinds;  pestilential  fevers,  the  purples  or  purpura.  Smallpox  and 
measles  are  treated  together — a  most  exhaustive  study  of  the 
manifestations  of  both  diseases  and  what  to  do  for  them.  He  has  a 
chapter  on  weak,  thin  infants.  Finally  he  takes  up  the  diseases  of 
various  parts  of  the  body.  One  example  will  serve,  that  on  diarrhea# 

Du  Flux  de  Ventre.  Mention  has  been  previously  made  of  diarrhea  as 
one  of  the  diseases  which  occur  in  infants  when  their  teeth  appear, 
and  especially  the  canines  and  eye  teeth :  Here  is  the  opportune  place  to 
speak  of  the  recbej  an  rang  of  the  diseases  of  the  abdomen.  The  flux  is  of 
several  varieties  which  come  at  all  ages,  we  do  not  hear  of  that  in  which 
the  food  is  passed,  very  much  as  it  is  eaten,  which  the  Greeks  call 
Lientery;  nor  of  that  with  skinning  of  the  intestines  which  the  Greeks 
call  Dysentery,  but  only  of  that  which  has  neither  of  these  but  which 
the  Greeks  and  also  Hippocrates  call  Diarrhea,  but  which  we  call 
emotion  du  ventre,  with  which  infants  are  most  often  affected. 

THE    CAUSES 

Many  causes  are  assigned,  one  the  pain  of  the  eruption  of  the  teeth 
which  impairs  the  digestion;  another  the  chilling  to  which  the  infant  is 
often  exposed  when  the  nurse  changes  it,  which  chilling  cools  and 
moistens  the  stomach;  the  third  is  gormandizing  by  the  child,  taking  in 
its  stomach  that  which  it  cannot  digest,  or  digesting  more  nourishment 
than  the  liver  has  need  for,  because  the  superfluity,  not  drawn  into  the 
liver,  flows  downward;  sometimes  also  an  abundance  of  choler  which 
descends  into  the  intestines  is  the  cause,  irritating  the  expulsive  power 
to  excretion,  also  the  expulsive  power  is  sometimes  stronger,  and  the 
retentive  weaker;  and  also  sometimes  the  affluence  of  the  choler  engen- 
ders in  the  stomach  a  corrupted  humor,  green,  yellow  or  otherwise, 
proceeding  from  crudity  and  of  strange  heat,  which  humor  nature  sends 
above  and  below;  but  the  disease  coming  from  this  cause  is  more  com- 
monly called  choleric  passion  than  flux  of  the  stomach. 


ClNQ^        LlVRES) 

De  la  manicrc  de  nourrir 

e  T      Cj  O  V  V  £  R  n  e<n^ 

LES     ENFANS      DES     LEVR 

NA      I      SSANC* 


&\d-  Sitrfon  de  V<tltambert,  Mededh  de  madams 
la  Ttachejfcs  de  Sauoycs  etde  "Berry ,  tt 
depuyspett  */o  temps,  d^j  monjei* 
gneur  io  2>#c  d'Orleans. 


jt   votcrttns, 
Par  lcs  dc  Marncfe,  &  Bouchctx,  fr crcs< 
I     i    6    i. 


Title  page  of  Vallembert's  "Cinq  Livres. 


250  PEDIATRICS  OF  THE  PAST 

THE  SIGNS  BY  WHICH  TO  TELL  FROM  WHAT  CAUSE  A  FLUX  OF  THE 

STOMACH  COMES 

That  which  comes  from  chilling  or  indigestion  returns  (vomits) 
only  phlegm  or  water  without  color  with  some  sharpness;  that  of  choler 
and  strange  heat  returns  green  or  yellow  matter  with  heat  of  the  body, 
great  thirst  and  alteration  of  the  tongue. 

PROGNOSIS  AND  JUDGMENT 

When  there  is  a  little  choler  mixed  with  the  phlegm  and  waters, 
better;  as  choler  alone  signifies  an  abundance  of  this  same  humor  in  the 
body  and  of  strange  heat  and  putrefaction:  the  waters  without  color, 
coldness  and  crudity:  the  meaning  of  the  color  is  this,  if  it  is  more 
whitish  there  is  nothing  bad  at  the  commencement  and  the  first  days 
may  be  endured.  Hippocrates  in  his  book  on  the  eruption  of  the  teeth 
speaks  of  the  flux  of  the  stomach  of  children:  "These:"  says  he,  "who 
pass  from  below  crudities  tinged  with  blood  are  most  frequently  asleep 
with  fever,  and  these,"  says  he  again,  "who  pass  from  below  humors  and 
scarcely  urinate  on  account  of  what  they  drink,  are  sickly." 

REMEDY 

As  soon  as  one  sees  that  the  flux  of  the  stomach  persists  too  long, 
that  is  to  say,  that  the  infant  is  weakened  by  it,  it  is  time  to  restrain  it, 
but  with  discretion:  for  if  it  is  green  and  yellow  and  the  child  big,  it 
should  first  be  given,  if  it  is  possible,  a  little  powdered  rhubarb  with 
syrup  of  dried  roses  and  on  the  next  day  a  clyster  of  a  decoction  of  barley 
and  plantain  with  a  very  little  rosat  honey,  then  another  of  starch  and 
the  juice  or  decoction  of  plantain,  or  of  other  astringent  things,  with 
rosat  oil  and  quince  oil  or  the  like:  cover  the  stomach  with  linen  moistened 
with  distilled  water,  or  a  decoction  of  myrrh,  of  roses,  or  of  plantain: 
then  a  plaster  of  sandol,  roses,  Armenian  bole  and  the  like,  incorporate 
an  astringent  oil  with  a  piece  of  wax:  or  a  cataplasm  of  spelt  (?)  or  of 
rye,  cooked  in  vinegar  and  sprinkled  with  the  said  oil :  give  starch  to 
eat  in  the  form  of  broth  and  lettuce  cooked  in  vinegar  and  water:  make 
them  drink  at  meals  and  between  of  the  syrup  of  grenadine,  or  of  quince 
or  of  dried  roses  with  chalybeate  water :  in  the  morning  some  spodium,  that 
is  to  say,  ivory,  alone  or  with  the  seeds  of  purslane  or  of  plantain,  dissolved 
in  fresh  water,  simple  or  chalybeate  water  or  barley  water;  some  boil 
the  seeds  of  the  cucumber,  with  three  fingers  of  the  mentioned  water: 
some  others  a  powder  made  of  seeds  of  Iapallele,  in  Latin,  Lapatum 
acutum,  and  of  raisin  seeds  cooked  in  the  oven,  as  much  of  one  as  the 
other,  with  the  greatest  quantity  of  glands  or  cormes,  roasted  nuts,  or 


SIMON  DE  VALLEMBERT  251 

of  Ientilles,  or  of  millet,  or  a  potage  of  quince;  others  make  a  flour 
ball,  cooked  in  a  cloth,  in  water  dried  and  hardened  in  the  form  of  a 
paste.  For  drink,  goats'  milk  to  which  one  has  added  steel,  or  of  water 
prepared  the  same,  alone  or  with  syrup  of  quince,  or  of  dried  roses  and 
sometimes  of  service  berries:  the  same  syrup  may  be  drunk  between  meals 
if  there  is  thirst,  with  syrup  of  mint  and  iron  water.  Before  the  repast  give 
a  scruple  of  gall  or  of  incense,  with  the  juice  of  quinces  or  of  codignac  or  of 
conserve  of  the  fruit  of  cornalier.  A  little  before  anoint  the  stomach  with 
a  decoction  of  rose  seeds,  of  coumin,  of  wild  cherry,  of  fellec  or  anise, 
on  the  advice  of  Oribasius:  then  place  below,  hot,  some  coumin  and  roses 
softened  in  vinegar,  mixed  together  to  form  a  cataplasm,  or  of  barley 
flour,  or  febue  cooked  with  sumac  and  honey. 

If  the  flux  comes  from  phlegm  only  and  of  chilling,  Avicenna 
fricassees  peeled  nuts  and  then  powders  them  with  sugar  and  administers 
as  much  as  the  size  of  a  filbert  with  cold  water;  and  others  place  on  the 
stomach  a  wax  plaster  of  saffron,  myrrh  and  wax  cooked  in  wine. 

For  the  flux  which  comes  from  teething,  the  child  should  be  bathed 
before  meals  in  rose  water  in  which  has  been  boiled  plaintain,  wormwood, 
roses,  wild  grenadine,  myrtles  and  other  similar  things;  or  one  applies 
to  the  stomach  plasters  as  described  above.  The  child  is  given  to  eat 
of  broth  to  which  has  been  added  powdered  myrtle  and  dragon's  blood, 
or  of  dried  service  berries  and  other  similar  astringents.  It  is  made  to 
suck  of  grenadine  j  uice,  or  of  quince  syrup  or  other  such  syrup.  Avicenna 
orders  a  powder  of  poppies,  myrtles,  cypress  and  incense  dissolved  in 
milk  to  be  sucked  or  drunk.  He  may  be  given  a  suppository  of  white 
lead,  acacia  or  similar  things. 


PHILIP  GERHARD  GROLING 

[1593- i  667] 

A  little-known  writer  on  pediatrics  who  merits  a  word  is  Philip 
Gerhard  Grilling  who  wrote  on  chemistry  and  gave  an 
.  account  of  the  various  chemical  and  Galenical  remedies.  His 
book  ran  through  several  editions.  He  likewise  contributed  a  vol- 
ume on  practice  of  medicine  and  in  1660  his  "Tractat  von  Kinder- 
Kranckheiten "  was  printed  at  Nordhausen.  He  states  that  the 
book  is  based  on  his  own  observations.  It  consists  of  forty  chapters 
starting  with  the  care  of  the  newborn,  the  bathing  of  young 
children,  the  diseases  and  accidents  of  young  children,  constipa- 
tion and  so  on.  He  was  strong  on  therapeutics  as  were  most  of  the 
men  of  his  day.  We  may  smile,  but  our  present-day  drug  catalogues 
will  cause  future  generations  to  do  likewise,  just  as  it  does  some 
of  us  today.  Some  of  Griiling's  suggestions  are  good  but  he  is  full 
of  the  usual  weird  suggestions :  hanging  coral  about  the  neck  and 
the  like.  He  groups  chicken-pox  with  measles  but  gives  some 
separate  rules  for  them  as  if  he  knew  they  were  two  diseases. 
He  gives  as  the  cause  that  the  child  in  utero  was  not  sufficiently 
cleansed  of  the  menstrual  blood.  One  chapter  is  headed:  "When  a 
child  becomes  sick  and  one  does  not  know  from  what,"  and  gives  a 
complicated  recipe  to  be  used  on  such  occasions.  He  must  have 
had  frequent  use  for  it. 

Philip  Gerhard  Grilling  was  born  in  1593  at  Stolberg  on  the 
Harz.  After  studying  medicine  he  settled  in  Nordhausen  and 
rendered  noteworthy  service  in  the  plague  epidemic  of  1626.  In 
1627  he  returned  to  his  native  village  where  he  lived  until  his 
death  that  same  year.  He  was  burgomeister  and  physician  to 
Count  Stolberg. 

Griiling's  book  is  largely  a  recipe  book,  recipes  after  the 
manner  of  the  time.  One  short  chapter  will  suffice  to  show  his 
style  and  give  a  glimpse  of  his  therapeutics. 

The  sixteenth  chapter  is  on  the  stopping  of  the  nose  of  young 
children: 

252 


PHILIP  GERHARD  GRULING  253 

This  disease  is  usually  caused  by  heat  [fever]  but  sometimes  is 
inherited. 

How  the  stopping  of  the  nose  of  young  children  may  be  relieved. 

Most  often  used  is  the  sweet  almond  oil  or  yellow  violet  oil  rubbed 
on  externally.     This  helps  greatly. 

Almond  oil  mixed  with  butter  is  also  good. 

Smear  the  nose  bone  with  goose  grease. 

Syringe  the  nose  with  mother's  milk,  or  mixed  with  a  little  marjoram 
water;  yellow,  violet  and  chamomile  oil  cooked  with  a  little  marjoram 
smeared  on  the  nose  bone  has  acted  well. 

Another. 

Ad  narium  obstructions 

Rec.  Unguent.  Dialthaeae  ein  halb  loth 

Pomad,  rosar  ana  2.  scrup. 

01.  Marjoram  gutt.  v 

Lavendalac  gutt.  11. 

Fiat  Iinimentum. 

Hoc  linimento  illinenda  nosi  regio  ad  internos  oculorum  angulos,  ubi  os 
cribri  forme. 

Smear  the  nose  bone  with  fresh  butter. 

Dip  a  feather  in  sweet  almond  oil  and  rub  it  in  the  nose. 


FRANCIS  GLISSON 

[1597- 1 677] 

THE  chief  facts  of  Glisson's  life  are  given  by  William  Munk 
in  the  "  Roll  of  the  Royal  College  of  Physicians,"  by  Norman 
Moore  in  the  "Dictionary  of  National  Biography,"  and  by 
John  Aikin  in  his  medical  biographies.  Glisson  will  always  be  one  of 
the  glories  of  English  medicine;  his  work  on  the  anatomy  of  the 
liver  will  always  be  remembered  as  his  name  is  associated  with  the 
capsule,  while  his  work  on  rickets,  the  second  monograph  of  any 
moment  on  a  single  disease  to  be  printed  in  England,  is  a  monu- 
ment to  his  powers  of  observation  and  description  which,  despite 
its  scholastic  setting,  must  always  be  regarded  as  a  masterpiece  of 
the  first  rank.  This  work  is  so  perfect  that,  apart  from  information 
afforded  by  technique  not  at  his  disposal,  little  of  value  has  been 
added  even  by  the  most  meticulous  pathologist.  Like  Robert 
Whytt's  treatise  on  "Dropsy  of  the  Brain,"  it  is  well  nigh  perfect 
as  a  piece  of  clinical  description. 

Francis  Glisson,  the  second  son  of  William  Glisson,  was  born 
at  Rampisham  in  Dorsetshire  in  1597,  and  was  sent  to  Caius 
College,  Cambridge,  in  161 7,  graduated  b.  a.  1621,  m.  a.  1624,  and 
was  incorporated  m.  a.  at  Oxford  in  1627.  His  m.  d.  was  a  Cam- 
bridge degree  conferred  in  1 634.  The  following  year  he  was  elected 
a  member  of  the  Royal  College  of  Physicians  and  was  made  regius 
professor  of  physic  at  Cambridge,  a  chair  which  he  held  to  his 
death,  but  to  which  he  evidently  did  not  devote  much  time.  In 
1675  he  appointed  Dr.  Brady  his  deputy  professor.  He  lectured 
on  anatomy  at  the  College  of  Physicians  and  in  1640  delivered  the 
Goulstonian  lectures.  The  anatomy  lectures  of  the  Royal  College 
were  read  in  turn  by  the  members  and  they  date  back  to  a  very 
early  period,  the  candidates  and  licentiates  were  summoned  to 
attend  them  and  liable  to  fine  if  they  did  not  do  so.  Under  Queen 
Elizabeth,  about  1565,  permission  was  granted  to  perform  dissec- 
tions within  the  college  walls.  The  subjects  were  afterwards  duly 
buried  in  the  parish  church  with  the  usual  religious  rites.   In 

254 


FRANCIS  GLISSON  255 

the  burial  register  of  St.  Martin's  Ludgate  is  an  entry:  "1615, 
February  28,  was  buried  an  anatomy  from  the  College  of 
Physicians." 

After  the  college  building  in  Amen  Corner  was  destroyed  by 
the  great  fire  of  1666,  the  lectures  were  apparently  merged  in  the 
Goulstonian  lectures.  These  lectures  were  established  by  the  will 
of  Dr.  Goulston,  who  died  in  1632.  He  left  two  hundred  pounds 
for  the  purpose  of  having  a  dissection  and  a  lecture  on  three 
consecutive  days.  The  lecturer  was  to  treat  of  three  or  more 
diseases  and  for  this  he  received  ten  pounds,  and  the  dissector 
two  pounds;  one  of  the  four  youngest  doctors  was  to  be  chosen. 
Glisson  was  the  second  lecturer  of  which  there  is  a  record. 

About  this  time  he  took  a  house  in  the  parish  of  St.  Mary's  at 
the  Walls,  in  Colchester,  and  practiced  physic  with  great  success. 
In  the  siege  of  1648,  he  was  present  in  the  town  and  was  chosen  by 
the  Royalists  to  confer  with  Lord  Fairfax,  but  his  interviews  were 
unsuccessful.  His  house  escaped,  although  there  was  much 
destruction  in  the  town,  which  was  so  impoverished  by  the  siege 
that  Glisson  made  up  his  mind  to  quit  it  for  London.  It  is  recorded 
that  on  previous  visits  he  had  occupied  lodgings  above  a  cutler's 
shop  next  to  the  Three  Kings  in  Fleet  Street.  In  the  Sloane 
collection  of  manuscripts  there  is  a  record  of  an  order  in  council 
issued  at  Whitehall  directing  the  payment  of  his  salary  as 
professor  which  was  in  arrears  for  five  years,  and  for  which  he 
had  petitioned. 

That  gossipy  old  biographer,  John  Aiken,  the  very  soul  of 
literary  industry,  records  that  Glisson  escaped  plague  by  thrusting 
bits  of  sponges  soaked  in  vinegar  up  his  nostrils.  Future  historians 
will  record  how  some  present-day  physicians  escaped  epidemic 
influenza  by  covering  the  nose  and  mouth  with  gauze,  while  the 
mucous  membranes  of  the  eyes  were  unprotected. 

Aiken  also  gives  another  instance  in  which  Glisson  is  cured, 
as  follows:  "He  had  been  three  weeks  afflicted  with  a  severe 
vertigo,  when,  after  other  remedies  had  failed,  he  was  cured  by 
a  plaster  of  flowers  of  sulphur  and  white  of  egg  applied  to  the 
whole  head  close  shaven." - 

Glisson  played  a  prominent  part  in  the  medical  and  scientific 
life  of  London ;  was  one  of  a  group  of  men  whose  meetings  led  to 
the  founding  of  the  Royal  Society  and  was  one  of  its  first  Fellows. 
In  the  Royal  College  of  Physicians,  he  was  censor  in  1656  and  was 


2S6  PEDIATRICS  OF  THE  PAST 

president  in  1667,  1668  and  1669.  The  College  of  Physicians  was 
founded  in  15 18  by  Henry  vm  at  the  behest  of  Linacre,  one  of  his 
own  physicians,  and  on  the  recommendation  of  his  chancellor, 
Cardinal  Wolsey,  to  improve  the  practice  of  the  art  of  physic 
and  to  repress  irregular,  unlearned  and  incompetent  practitioners. 
It  had  its  vicissitudes  and  changed  its  home  many  times.  Just 
before  Glisson  was  president  it  had  occupied  a  stately  new  building, 
the  gift  of  the  generous  Harvey.  This  building,  opened  in  1654, 
was  in  Amen  Corner,  and  the  college  garden  extended  to  the  Old 
Bailey.  The  fire  of  1666  destroyed  this  and  in  the  confusion  follow- 
ing, it  was  not  until  1 669  that  a  new  site  in  Warwick  Lane  was 
chosen.  Glisson  gave  a  hundred  pounds  toward  this  and  eventu- 
ally Sir  John  Cutler  erected  a  stately  building  after  designs  fur- 
nished by  Sir  Christopher  Wren.  Readers  of  Garth's  "Dispensary" 
may  remember  the  description. 

A  dome,  majestic  to  the  sight, 
And  sumptuous  arches  bear  its  oval  height; 
A  golden  globe  plac'd  high  with  artful  skill, 
Seems  to  the  distant  sight,  a  gilded  pill. 

Garth  refers  to  Glisson  himself:1 

I  show'd  of  old  how  vital  currents  Glide, 

And  the  meanders  of  their  refluent  Tide: 

Then  Willis,  why  spontaneous  Actions  here, 

And  whence  involuntary  motions  there: 

And  how  the  Spirits  by  Mechanical  Laws, 

In  wild  Careers  tumultuous  Riots  cause. 

Nor  would  our  Wharton,  Bates  and  Glisson  lye 

In  the  Abyss  of  blind  Obscurity. 

But  now  such  wond'rous  Searches  are  forborn, 

And  Paean's  Art  is  by  Divisions  torn. 

Then  let  your  Charge  attend,  and  I'll  explain 

How  her  lost  Health,  your  Science  may  regain. 

The  disease  rickets  doubtless  has  existed  from  early  times, 
but  not  until  1634  did  it  appear  in  the  Bills  of  Mortality.  Glisson 
thought  it  a  disease  that  had  but  lately  appeared  and  so  made  a 
study,  of  which  more  later.  His  "De  Rachitide"  appeared  in  1650, 
to  be  followed  by  "Anatomia  Hepatis,"   in    1654  and  by  his 

1  Garth,  S.  Dispensary,  canto  vi. 


»i»»IIII!ll»lil«l!iill!!llIliPlll!!li!i!|i!ll»l 

Francis  Glisson 
[1597-1677] 


FRANCIS  GLISSON  257 

"Tractatus  de  Natura  Substantiae,"  in  1672.  His  last  work  was 
printed  in  1677  and  was  entitled  "Tractatus  de  Ventriculo  et 
Intestinis." 

His  fame  as  an  anatomist  was  widespread;  he  had  evidently 
good  judgment  coupled  with  remarkable  powers  of  observation. 
Boerhaave  characterizes  him  as  Omnium  anatomicorum  exactissi- 
mus,  and  Haller  referring  to  one  of  his  books  says:  "Egregius 
liber,  ut  solent  hujus  viri  esse."  The  work  of  the  stomach  and 
intestines  was  taken  from  his  earlier  lectures.  The  "Tractatus  de 
Natura  Substantiae"  is  described  by  Munk  as  follows: 

It  is  a  profound  and  laborious  performance,  in  the  very  depths  of  the 
Aristotelian  philosophy  with  all  its  numerous  divisions;  and,  though  in 
system  and  manner  now  obsolete,  deserves  admiration  as  an  extraor- 
dinary effort  of  the  understanding  of  a  man  of  an  advanced  age. 

Foster,  in  his  lectures  on  physiology,  says  of  it : 

This  is  a  bold  attempt  to  show  that  all  phenomena  as  well  as  all  living 
things,  be  they  animal  or  vegetable,  as  of  things  not  alive  are  the  succes- 
sive developments  of  the  one  fundamental  energy  of  nature. 

Foster  also  calls,  .attention  to  the  fact  that  he  was  the  first  to 
use  the  word  and  the  idea  of  "irritability"  which  has  meant  so 
much  to  modern  physiology  and  which  was  revived  by  Haller  a 
century  later. 

Glisson  died  in  London  October  14,  1677,  and  was  buried  in 
the  parish  church  at  St.  Bride,  Fleet  Street.  His  portrait  at  the 
age  of  seventy-five  adorns  the  walls  of  the  College  of  Physicians. 

Glisson  lived  in  stirring  times.  In  his  youth  the  conquest  of 
Ireland  was  going  on  and  when  he  was  five  Queen  Elizabeth, 
whose  reign  produced  so  many  remarkable  men,  died.  Then  came 
the  Stuarts  with  their  "Divine  Right  of  Kings"  idea,  to  be 
followed  by  the  contentions  of  the  Puritans,  the  Romanists  and 
others.  The  point  of  interest  is  that,  in  spite  of  all  the  diverting 
circumstances,  Glisson  worked  quietly  on,  as  men  of  science  have 
always  worked,  regardless  of  the  politics  of  the  day.  The  Protector 
ate  was  a  trying  time  and  even  the  Lord's  Prayer  was  recited  as 
"Thy  Commonwealth  come,"  but  out  of  this  rough  soil  grew  some 
of  the  flowers  of  English  medical  literature. 

Glisson's  treatise  on  rickets  was  published  in  1650,  and  in  the 
preface  there  is  the  statement  that  the  work  had  been  carried 


258  PEDIATRICS  OF  THE  PAST 

out  for  more  than  five  years  previously;  but  this  publication 
was  preceded  five  years  by  a  little  book  by  Daniel  Whistler, 
originally  printed  at  Leyden  and  reprinted  in  1684,  when  Whistler 
was  president  of  the  College  of  Physicians.  The  treatise  was  a 
disputation  on  rickets  held  on  October  18,  1645,  at  Leyden  for 
the  degree  of  Doctor  of  Physic.  Norman  Moore  has  given  an 
interesting  account  of  this  little  book.2  The  original  bears  the 
cut  of  a  bird  trying  to  swallow  what  appears  to  be  a  horseshoe 
and  of  which  Norman  Moore  remarks:  "The  bird's  supposed 
power  of  digesting  iron  seems  to  have  made  Dutch  book  sellers 
think  it  an  appropriate  symbol  of  the  capacity  for  assimilating 
knowledge  in  its  toughest  forms."  In  1876,  in  his  thesis  for  the  m.  d. 
degree  at  Cambridge,  Moore  spoke  harshly  of  Whistler  and 
questioned  the  original  publication,  but  William  Munk  found  a 
copy  in  an  obscure  cupboard  in  the  College  of  Physicians  and 
another  copy  is  in  the  British  Museum. 

Whistler  made  no  claim  to  discovering  the  disease,  but 
proposed  a  new  name  (the  everlasting  tendency  to  use  new  terms, 
the  curse  of  learning),  Paedosteosplanchnocaces,  which  reminds 
one  of  Achilles  Rose  suggesting  the  use  of  Kleidokymbalon  for 
piano,  or  skolekorditis  for  appendicitis.  The  book  gives  a  descrip- 
tion of  the  disease,  but  Moore  does  not  give  him  much  credit, 
believing  that  Whistler  had  heard  the  disease  talked  about 
rather  than  studied  it. 

Whistler  was  a  picturesque  character  of  great  charm  of  manner, 
whose  dealings  were  questionable.  He  attained  many  high  offices 
and,  as  Munk  says,  "in  an  evil  hour  he  was  elected  President  of 
the  Royal  College  in  1683."  He  defrauded  the  College  in  some  way 
"but  in  what  precise  manner  or  to  what  extent  is  not  recorded. " 
Samuel  Pepys  speaks  of  him  as  "good  company  and  a  very 
ingenious  man"  and  Evelyn  calls  him  "the  most  facetious  man 
in  nature." 

In  addition  to  Whistler's  book  there  are  two  other  citations 
usually  made  in  the  history  of  rickets.  Arnold  de  Boot,  1606- 
1650,  a  Dutchman  who  served  in  the  English  Army  in  Ireland, 
mentions  the  disease  in  his  "  Observationes  medicae  de  affectibus 
omissis,"  London,  1649.  There  is  also  a  work  entitled  "Flagellum 
Angliae  seu  Tabes  Anglica,"  which  has  been  regarded  by  some  as 

2  Moore,  N.  The  history  of  the  first  treatise  on  rickets,  St.  Bartb.  Hosp.  Rep., 
xx,  71,  1884. 


Frontispiece  of  Glisson's  Book  on  Rickets. 


FRANCIS  GLISSON  259 

referring  to  rickets,  but  according  to  Gee  and  Billings  it  is  an 
obscure  form  of  consumption.  When  we  come  to  Glisson's  master- 
piece we  are  reminded  of  the  remark  that  Milton's  "Paradise 
Lost"  is  a  fine  work,  but  no  one  has  yet  been  seen  who  wished  it 
one  line  longer.  Glisson  wrote  in  the  manner  of  the  time,  verbose, 
argumentative,  reiterating.  It  was  the  fashion.  John  Mayow, 
who  used  the  direct  scientific  statement,  was  neglected.  His  style 
was  not  appreciated.  Glisson  deserves  all  the  credit  he  gets  for  his 
painstaking  work,  but  he  managed  to  mix  up  the  facts  with  the 
discussion,  so  that  it  takes  a  long  period  of  close  attention  to  dig 
out  what  he  did.  It  is  not  necessary  to  give  a  summary,  for  it 
was  admirably  done  by  Mayow  and  will  be  quoted  in  the  con- 
sideration of  that  author,  but  a  few  quotations  will  be  given  to 
show  the  style  of  the  work. 

"De  Rachitide,"  published  in  1650  in  Latin,  was  translated 
into  English  by  Philip  Armin.  This  was  enlarged  and  corrected  by 
Nicholas  Culpepper,  Gent.,  student  in  physick  and  astrology,  and 
printed  by  John  Streater  to  be  sold  by  George  Sawbridge,  dwell- 
ing on  Clerkenwell-Green. 

The  work  was  one  of  collaboration,  participated  in  by  Glisson, 
T.  Sheafe,  George  Bate,  Ahasuerus  Regemonter,  R.  Wright,  N. 
Paget,  J.  Goddard  and  E.  Trench,  all  members  of  the  College  of 
Physicians  at  London.  The  preface  by  Glisson,  Bates  and  Rege- 
monter states  that  they  were  appointed  a  committee  to  collect 
and  edit  the  papers,  prepared  by  various  members  and  commu- 
nicated in  private  meetings.  The  work  had  lasted  some  five  years. 

But  when  Dr.  Glisson  in  the  judgement  of  the  rest,  had  accurately 
mterweaved  his  part  (which  comprehending  the  finding  out  of  the  essence 
of  this  disease)  and  in  that  he  had  propounded  many  things  different 
from  the  common  opinion  of  Physitians  (though  perhaps  the  less  differ- 
ent from  the  truth)  we  altered  our  Resolutions,  and  committed  the 
first  stuff  of  the  whole  work  to  be  woven  by  him  alone,  least  at  length 
the  part  should  arise  deformed,  misshapen  and  Heterogeneous 
to  themselves. 

The  book  starts  out  with  some  notes  about  the  antiquity  of 
disease  and  the  name.  He  dwells  on  the  fact  that  the  disease  is 
not  luetic  in  nature,  but  a  new  disease.  Leonard  Findlay3  states 
that  there  is  no  mention  of  rickets  in  the  Ebers,  Brugsch  or 

8  Findlay,  L.  Glasgow  Med.  J.t  xci,  147,  19 19. 


260  PEDIATRICS  OF  THE  PAST 

London  papyri.  Elliot  Smith  found  no  rickets  in  the  ancient 
Egyptians  but  some  skeletons  showed  bending  in  the  long  bones. 
Lortch  found  rickets  in  the  skeletons  of  monkeys  which  had  been 
kept  in  captivity  in  Thebes.     [See  also  Soranus.] 

Some  have  conjectured,  that  this  Disease  is  an  imp  or  fruit  of  the 
French-Pox  or  Scurvy,  descending  from  the  vitiated  Bodies  of  the 
Parents  upon  the  Children:  For  we  deny  not  but  the  Parents  being 
infected  with  the  Scurvy  or  the  venereous  Pox,  may  propagate  and 
bring  forth  an  Issue,  not  only  affected  with  that  Pox  &  Scurvy,  but 
likewise  infected  with  this  evil,  and  this  even  hath  also  fain  under 
Observation:  yet  for  the  most  part  this  Disease  in  the  propriety  of  its 
Essence,  hath  neither  affinity  nor  familiarity  with  those  affects,  and 
besides  it  requireth  a  different  progress  of  cure;  we  have  sometimes 
likewise  observed  a  strumatical  and  swelling  Malady  to  be  complicated 
with  this;  but  we  have  also  many  times  beheld  this  to  be  well  distin- 
guished from  that,  and  that  from  this. 

But  why  do  we  dwell  so  long  upon  this  inquisition?  seeing  that  he, 
who  will  accurately  contemplate  the  signs  of  this  affect,  as  in  their  due 
places  shall  be  propounded,  may  most  easily  perswade  himself,  That  this 
is  absolutely  a  new  Disease,  and  never  described  by  any  of  the  Ancient 
or  Modern  Writers  in  their  practical  Books  which  are  extant  at  this  day, 
of  the  Diseases  of  Infants. 

But  this  Disease  became  first  known  (as  near  as  we  could  gather  from 
the  Relation  of  others  after  a  sedulous  enquiry)  about  thirty  years  since, 
in  the  Counties  of  Dorset  and  Somerset,  lying  in  the  western  part  of 
England;  since  which  time  the  observation  of  it  hath  been  derived  unto 
other  places,  as  London,  Oxford,  Cambridge,  and  almost  all  the  Southern 
and  Western  parts  of  the  Kingdom :  in  the  Northern  Counties  this  affect 
is  very  rarely  seen,  and  scarcely  yet  made  known  among  the  Vulgar 
sort  of  people. 

The  most  received  and  ordinary  Name  of  this  Disease  is,  The 
Rickets:  But  who  baptiz'd  it,  and  upon  what  occasion,  or  for  what 
reason,  or  whether  by  chance  or  advice  it  was  so  named,  is  very  uncertain. 

And  finally,  the  English  name  Rickets  received  with  so  great  a 
consent  of  the  people,  doth  by  this  Name  seem  to  be  excused,  yea, 
justified  from  Barbarism.  For  without  any  wracking  or  convulsion 
of  the  word,  the  name  Rickets  may  be  readily  deduced  from  the  Greek 
word  Rachitis,  or  Racbites;  provided,  That  we  will  but  allow  that 
consideration  of  change,  which  in  vulgar  pronunciation  usually  happen- 
eth  to  words  transplanted  from  one  Language  to  another. 

Object.  You  will  say,  That  they  which  imposed  first  the  English  name 
Rickets,  were  peradventure  altogether  unskilful  in,  and  ignorant  of  the 


FRANCIS  GLISSON  261 

Greek-tongue,  or  that  they  never  thought  0/  the  Greek  word  Rachites,  at 
least  understood  not  that  the  Spine  of  the  Back  was  the  principal  among 
those  parts  which  were  first  affected  in  this  Disease? 

Answer.  We  answer,  It  concerns  not  us,  whether  they  were  ignorant 
of,  or  thought  not  upon  the  Greek  word,  or  whether  they  did  not  under- 
stand the  principal  part  that  was  first  affected;  yet  are  those  things 
freely  asserted.  For  we  knew  many  at  that  time  when  the  Disease  did 
first  spring  up,  and  the  Name  was  imposed,  indeed  learned  men,  and 
skilful  in  the  Greek  tongue,  to  have  their  Residence  in  those  places, 
to  whom  it  was  not  perhaps  any  difficulty  to  observe  that  conscious 
debility  of  the  Spine  in  this  affect,  and  thereupon  they  might  assign  this 
Name  unto  it;  although  'tis  very  possible,  yea  probable,  That  the 
common  people  by  the  error  of  pronunciation  might  somewhat  pervert 
the  Name  so  given,  and  express  it,  as  to  this  day  they  retain  it  by  the 
word  Rickets.  But  whether  it  were,  or  were  not  so,  we  are  not  at  all 
solicitous.  If  the  matter  were  so,  the  imposed  Name  will  (as  is  manifest) 
be  altogether  congruous,  and  perhaps  also  at  the  last  will  most  fitly  corre- 
spond with  it.  For  suppose  you  should  fall  upon  some  Name,  received 
not  so  much  by  choice  as  chance,  yet  so  fit,  that  a  more  commodious 
Name  could  scarce  be  devised  by  councel  and  deliberation,  nor  one  more 
consonant  to  Reason;  in  such  a  Case,  What  would  you  do?  Would  you 
extirpate  and  banish  the  received  word,  to  introduce  one  that  was  new 
and  nothing  better?  This  practice  would  usurp  upon  the  priviledge  of 
Conversation,  and  be  injurious  to  the  custom  of  Speaking:  Words 
contract  a  value  by  their  use,  and  ought  not  to  be  dinizen'd  with  rash- 
ness, or  onnovated  by  temerity:  Or  would  you  not  rather  confirm  the 
Name  received,  yet  as  a  new  one,  and  from  that  time  to  be  deduced  from 
a  new  Origine:  for  this  would  be  at  the  least  like  a  chosen  Scynos  inocu- 
lated upon  a  new  stock,  which  by  reason  of  the  affinity  with  the  Root, 
would  without  any  difficulty  receive  strength  and  nourishment:  Or  if 
this  please  you  not,  suppose  if  you  please,  That  we  now  newly  devised 
the  English  name  of  this  Disease,  and  deduce  it  from  the  Greek  word 
Racbites:  the  English  word  resulting  from  hence  would  be  the  Rachites: 
and  how  little  is  the  difference  between  that  and  the  ordinary  word 
Rickets?  Certainly  so  little,  That  the  vulgar  pronunciation  is  not  wont 
to  be  greatly  solicitous  about  so  small  a  difference:  But  we  trifle  too 
much  in  staying  so  long  upon  these  trifles.  Let  the  Greek  name  therefore 
of  the  Disease  be  nosis  Rachitis,  or  Rachites  (if  the  word  may  be  allowed 
to  be  of  the  common  Gender)  or  tes  Racbeos;  in  Latin  Morbus  Spinalis, 
vel  Spinae  Dor  si:  and  by  coyning  a  Latin  Substantive  out  of  the  greek 
Adjective  Racbitis-idis  let  the  ordinary  English  name  Rickets  be  retained, 
or  in  stead  of  it,  to  gratifie  more  curious  ears,  you  may  substitute  the 
Racbites.  And  thus  much,  if  not  too  much  of  the  Name. 


262  PEDIATRICS  OF  THE  PAST 

The  origin  of  the  word  Rickets  is  also  attributed  to  a  word 
from  the  Dorset  dialect  To  Rucket:  to  breathe  with  difficulty. 
Skeats  says  it  is  from  the  Old  English  "Wrick"  or  the  Middle 
English  "  Wrikken,"  to  twist,  as  "to  wrick  one's  ankle." 

The  examination  of  bodies  of  children  dead  from  this  disease 
led  Glisson  to  describe  the  gross  pathological  changes,  which  he 
did  as  follows: 

These,  our  Anatomical  Observations  are  distinguished  into  those  which 
do  extrinsecally  occur,  the  Body  being  not  yet  opened,  and  those  which 
present  themselves  only  upon  the  Dissection  oj  the  Body. 

I.    THOSE  OF  THE  FORMER  KIND  ARE  THEY  WHICH  ARE  OUTWARDLY 
VISIBLE  UPON  THE  FIRST  APPEARANCE  OF  THE  NAKED  DEAD  BODY 

1.  An  irregularity,  or  disproportion  of  the  parts;  namely,  The  Head 
bigger  than  ordinary,  and  the  Face  fat  &  in  good  constitution  in  respect 
of  the  other  parts.  And  this  indeed  hath  appeared  in  all  those  whom 
hitherto  we  have  beheld  to  perish  by  this  affect,  one  onely  excepted,  who 
together  with  this  Disease  had  suppurated  Lungs,  and  was  pined  and 
disfigured  with  the  Ptysick.  Yet  he  also  throughout  the  whole  progresse 
of  the  Disease,  was  full  faced,  and  had  his  head  somewhat  big;  but  for 
about  fourteen  dayes  before  he  Deceased,  on  a  sudden  all  the  fleshy 
parts  about  his  head  consumed  away,  and  his  face  was  like  the  picture  of 
Hypocrates,  not  without  the  just  wonder  of  all  those  who  beheld  so 
sudden  a  change. 

2.  The  external  members,  and  the  muscles  of  the  whole  Body  were 
slender  and  extenuated,  as  if  they  had  been  wasted  with  an  Atrophy, 
or  a  Consumption.  This  (for  so  much  as  we  know)  is  perpetually  observed 
in  those  that  die  of  this  Disease. 

3.  The  whole  Skin,  both  the  true,  and  also  the  fleshy  and  fattish 
Membrane,  appeareth  lank  and  hanging,  and  loose  like  a  Glove,  so  that 
you  would  think  it  would  contain  a  far  greater  quantity  of  flesh. 

4.  About  the  joynts,  especially  in  the  wrists  and  ankles  certain 
swellings  are  conspicuous,  which  if  they  be  opened,  not  in  the  fleshy  or 
membranous  parts,  but  in  the  very  ends  of  the  bones,  you  may  perceive 
them  to  be  rooted  in  their  appendances;  and  if  you  will  file  away  those 
prominencies  of  the  bones,  you  will  easily  perceive  them  to  be  of  the 
same  similarly  substance  with  the  other  parts  of  the  bones. 

5.  The  articles  or  joynts,  and  the  habits  of  all  the  external  parts 
are  less  firm  and  rigid,  and  more  flexible  then  at  another  time  they  are 
observed  to  be  in  dead  bodies;  and  in  particular  the  Neck  after  death  is 
scarce  stiff  with  cold,  at  least  much  less  then  in  other  Carkasses. 


FRANCIS  GLISSON 


263 


6.  The  Brest  is  outwardly  lean,  and  very  narrow,  especially  under  the  bT«t  where  thee 
arms,  and  seemeth  on  the  sides  to  be  as  it  were  compressed,  the  Stern  nbs  mect* 
also  is  somewhat  pointed,  like  the  Keel  of  a  Ship,  or  the  brest  of  a  Hen. 

7.  The  top  of  the  ribs  to  which  the  stern  is  conjoyned  with  gristles, 
are  knotty,  like  unto  the  joynts  of  the  Wrists  and  Ankles,  as  we  have 
already  said. 

8.  The  Abdomen  indeed  outwardly  in  respect  of  the  parts  continent 
is  lean,  but  outwardly  in  respect  of  the  parts  contained  it  is  somewhat 
sticking  out,  and  seemeth  to  be  sweld  and  extended.  And  these  have 
been  our  Observations  before  the  opening  of  the  bellies. 

II.    THE  ABDOMEN  BEING  OPENED,  WE  HAVE  NOTED  THESE  THINGS: 

1 .  The  Liver,  in  all  that  we  have  dissected,  hath  exceeded  in  bignesse, 
but  was  well  coloured,  and  not  much  hardned,  nor  contaminated  by 
any  other  remarkable  vice.  We  desire  some  bodies  should  here  be 
excepted,  in  which  other  Diseases  before  death  were  complicated  with 
this,  as  in  a  Dropsie  and  an  extream  Consumption  we  remember  to  have 
hapned. 

2.  The  Spleen  (namely  so  far  as  hitherto  it  hath  been  lawful  for  us  to 
observe)  for  the  most  part  is  not  to  be  condemned,  whether  you  consider 
the  magnitude,  the  colour,  or  the  substance  of  it,  notwithstanding  we  do 
not  deny  but  it  may  otherwise  happen  in  regard  of  a  complication  with 
other  Diseases. 

3.  We  have  sometimes  espied  a  wheyish  water  to  have  glided  into 
the  cavity  of  the  Abdomen,  but  indeed  not  often,  nor  in  any  great  plenty. 

4.  The  Stomach  and  Guts  are  somewhat  more  infected  with  flatulent 
humors,  then  sound  bodies  usually  are,  which  partly  may  be  the  cause  of 
that  extension  of  the  Hypochondricall  parts  above  mentioned. 

5.  The  Mesentery  is  sometimes  faultlesse,  and  sometimes  affected 
with  glandulous  excrescences  bigger  than  ordinary,  if  not  with  swelling 
bunches:  But  concerning  the  sweet-bread  we  declare  nothing  for  a  cer- 
tainty; only  we  suspect  that  Obstructions,  if  not  a  Schirrhus,  may  some- 
times invade  that  part.  But  this  we  delegate,  to  the  enquiry  of  others. 

6.  The  Kidneys,  Uretors  and  Bladder,  unlesse  there  be  a  concomi- 
tancy  of  some  other  Disease,  are  laudably  sound.  We  observe  in  general 
of  all  the  Bowels  contained  in  this  Belly,  that  although  the  parts  con- 
taining them,  as  we  have  noted  above,  are  very  much  extenuated  and 
amaciated,  yet  are  they  as  large  and  as  full,  if  not  larger  and  fuller,  then 
those  seen  in  sound  bodies,  as  hath  been  said  of  the  liver. 


III.    THE    STERNE  BEING   WITH-DRAWN,    THESE   THINGS   HAVE    PRE- 
SENTED THEMSELVES  IN  THE  BREST 

i.  A  certain  adherence  or  growing  to  of  the  Lungs  with  the  Pleura 
which  hath  been  more  or  Iesse  discernable  in  all  the  Bodies  which  hith- 


A  thin  and 
smooth  skin 
which  cloatheth 
the  ribs  on  the 
inner  side. 


RACHITIDE 

MORBOPUERILI. 

qui  vulgo 

The  mOtttS  dicitur, 

Traftitus; 

Opera  pnm\ac  potifsimum 

FRANCISCJ'^LISSONII 
Do&oris  &  publici  Fkofcflbris  Medi- 
cine in  alma  Cantabngit  Academia, 
&   Sodi  Collcgii  Mcdicorum 
ZWw^WjConfcriptus  : 

Adfcitls  in  operis  focictatcm 
GEORGIO      BATE, 

AHASUERO  REGEM0RTER.0 

M(dtcin£  quoque  Deftoribut^  &  pbritcr  Sociis 
Collegti  Mcdicorum  Londinenfium. 


£  0  N  V  1  N  I, 

ypit  Gut  I.  Du-gar  di  i  Impends  L<wnntii  Sadler,  & 
Kobcm  Beaumont :  apud  quos  veneunt  in  vico 
Yulgd-vocaco  HUU  S&Mflfn  ^\6;q. 


Title  page  of  the  first  edition  of  Glisson's  book  on  rickets. 


FRANCIS  GLISSON  265 

erto  we  have  cut  up.  Yet  we  suppose  this  affect  may  happen  without  any 
such  nourishment,  although  in  the  advancement  of  the  Disease  for  the 
most  Part  it  cometh  before  the  Patient  die. 

2.  The  stoppings  or  stuffings  of  the  Lungs  are  no  less  frequent, 
especially  in  those  co-adhering  parts.  Hard  humours  also  engendered  by 
a  thick,  viscous  and  blackish  blood,  sometimes  in  one,  sometimes  in  many 
of  the  strings  of  the  Lungs,  yet  are  not  these  alwayes  conspicuous,  many 
times  also  Imposthums  and  Ulcers. 

3.  One  amongst  us  doth  attest,  That  he  once  saw  glandulous  knobs 
and  bunches,  so  numerous,  That  they  seemed  to  equalize,  if  not  exceed 
the  magnitude  of  the  Lungs  themselves:  They  were  situated  on  both 
sides  between  the  Lungs  and  the  Mediastinum  (that  is  the  Membrane 
that  divides  the  middle  belly)  and  were  extended  from  the  Chanel  bone 
to  the  Diaphragma. 

4.  In  the  cavity  of  the  Brest  we  have  sometimes  seen  a  collection  of 
wheyish  waters,  and  indeed  more  frequently  then  in  the  cavity  of  the 
Abdomen,  but  not  in  all. 

5.  One  amongst  us  hath  likewise  seen  this  affect  complicated 
with  a  great  Imposthume,  and  with  the  Ptysick:  the  Stern  being 
removed,  all  the  Lungs  on  the  left  side  were  infected  with  an 
Imposthume,  and  on  every  side  growing  to  the  Pleura,  and  the  humour 
being  slightly  crushed,  a  copious,  thick  and  stinking  Matter  of  a  yellow- 
ish colour,  flowed  out  thorow  the  sharp  artery  into  the  very  mouth: 
The  outward  Membrane  of  the  Lungs,  whereby  they  firmly  adhered  to 
the  Pleura,  appeared  thicker  then  ordinary,  and  by  the  mediation  of  it, 
the  strings  on  that  side  did  so  grow  together,  that  you  could  scarce 
distinguish  them  for  such:  the  same  Membrane  also  involved  both  the 
Lungs  and  also  the  Imposthume  it  self,  which  being  opened,  the  magni- 
tude of  the  Imposthume  was  discernable,  which  by  the  estimation  of 
those  that  were  present,  contained  at  the  least  two  pounds  of  water. 

6.  The  kernel  in  the  Chanel-bone  in  Childhood  is  always  observed 
to  be  great,  and  perhaps  greater  yet  in  those  who  have  died  of  this  Disease. 

iv.  the  skull  being  sawed  thorow  in  a  circular  figure,  and 
the  little  cover  being  removed,  we  have  observed  these 

things: 

i.  The  Dura  Mater  hath  been  more  firme,  and  adhered  to  the  Skull 
in  more  places  than  is  usual  in  men  of  ripe  years:  perhaps  the  same  may 
be  observed  in  other  Children  not  affected  with  this  evil,  although,  as  we 
suppose,  not  in  so  great  a  manner:  for  certain  it  is,  That  in  new  born 
Infants  there  are  many  &  straight  connexions  between  the  Pericranium 
and  the  Dura  Mater  which  are  afterwards  broken  off,  and  are  scarce 
discernable. 


266  PEDIATRICS  OF  THE  PAST 

2.  In  some  Bodies  that  we  have  dissected  between  the  Dura  and  the 
Pia  Mater,  and  in  the  very  ventricles  of  the  Brain,  we  have  found 
wheyish  and  waterish  humors:  from  whence  it  is  manifest,  That  this 
affect  is  complicated  with  the  Hydrocephalus. 

3.  We  have  found  the  Brain  in  others  that  we  have  opened,  to  be 
firm  and  inculpable,  and  not  overflowed  with  any  waterish  congestions. 

4.  Lastly,  We  have  observed  in  some  Bodies  lately  opened,  That 
the  Carotides  have  exceeded  their  just  proportion,  and  so  also  have 
the  jugulary  Veins;  but  the  Arteries  and  the  Veins  which  are  delated  to 
the  outward  parts,  were  of  an  unusual  slenderness. 

But  whether  or  no  this  be  perpetual  in  this  affect  we  cannot  yet 
witness  by  an  ocular  testimony;  yet  we  conjecture,  That  it  happeneth 
so  perpetually,  but  it  came  not  sooner  into  our  minds  to  examine  it, 
since  the  beginning  of  our  Anatomical  enquiries  into  this  subject. 

These  things  being  premised,  our  next  Disquisition  shall  be  to  find 
out  the  Essence  of  the  Disease. 

He  proceeds  to  a  long  disquisition  on  the  "essence"  of  the 
disease,  natural  constitutions  and  the  like,  done  in  his  best  clinical 
style  and  quite  different  from  the  sprightly  style  of  many  of  his 
contemporaries,  Pepys  for  example.  It  is  not  necessary  to  spend 
much  time  over  this  portion  of  the  book  unless  one  seeks  for  an 
example  of  the  medical  argument  of  the  time.  The  effect  of  the 
Middle  Ages  when  men  thought  out  disease  rather  than  observed 
it,  had  not  passed,  so  Glisson  argues  "that  the  essence  of  this 
disease  consists  not  in  the  Animal  or  Vital,  but  in  the  natural 
constitution,  not  as  organical,  but  as  a  similar."  Which  one  takes 
to  mean  that  the  disease  is  one  affecting  the  entire  body,  all  the 
tissues,  and  is  not  due  to  disease  in  any  one  organ  or  to  a  lack 
of  nervous  or  blood  supply.  He  proposes  the  question,  "Is  the 
disease  a  'cold  distemper/  that  is,  afebrile  (?)  and  decides  that 
it  is  "moist,"  as  a  "cold  distemper  doth  very  rarely  continue 
long  without  a  moist."  He  finally,  after  considerable  discussion, 
concludes  "that  the  benumbed-ness  of  the  Spirits  in  this  affect 
deserveth  a  particular  and  distinct  consideration." 
.   A  good  example  of  Glisson's  style  is  the  following : 

By  Common  Qualities  we  understand  in  a  manner  the  same  which 
some  others  have  called  the  Madas  Materiae,  and  others  Qualitates 
Secundas.  Now  we  call  them  Common,  because  they  are  not  restrained 
to  any  one  Element  or  Form;  but  in  some  sort  may  expiate  and  range 
thorow  all  the  Bodies,  and  for  the  most  part  affect  them  more  or  less. 


FRANCIS  GLISSON  267 

Of  this  sort  are  density,  rarity,  consistence,  fluidness,  tenacity,  friability, 
laxity,  tension  (or  rather  tensity,  that  the  habit  may  be  distinguished 
from  the  action)  witheredness,  swelling  and  stifness,  softness,  hardness, 
smoothness,  roughness.  But  it  is  not  our  meaning,  exactly  to  reckon  up 
all  and  each  of  the  Common  Qualities,  not  to  prosecute  those  already 
rehearsed,  further  then  the  present  occasion  shall  require. 

The  Tone  or  Harmony  of  the  Parts  doth  seem  to  result  from  some 
Common  Qualities  mutually  embraced  among  themselves.  For  the  Tone 
of  the  Parts  properly  consisteth  in  a  due  tenor  and  mediocrity  between 
certain  opposite  Common  Qualities,  as  between  thickness  and  thinness, 
&c.  But  if  there  be  a  recess  or  departure  from  the  just  mediocrity  to 
either  of  the  extreams,  then  there  is  a  necessity  that  the  Tone  must  be 
vitiated.  Two  things  therefore  do  here  seem  to  be  enquired  after  con- 
cerning the  Tone  of  the  Parts;  the  first,  whether  this  Disease  of  the  Tone 
of  the  Parts  be  in  any  degree  vitiated.  The  next,  Whether  those  faults 
of  the  Tone  do  belong  to  the  secondary  Essence  of  the  Disease. 

As  concerning  the  first,  It  will  be  unnecessary  to  run  thorow  the 
particular  Parts  of  the  Tone  severally,  it  will  be  sufficient  to  examine 
those  that  seem  guilty  of  the  suspected  crime. 

After  a  discussion  of  many  pages,  he  concludes: 

And  so  all  these  things  being  rightly  weighed,  we  refer  the  vitiated 
Tone  to  the  secondary,  nor  the  primary  Essence  of  this  affect,  and  by 
consequence  we  conclude,  indeed  the  thing  that  was  in  question,  that 
that  depraved  Tone  is  a  secondary  part  of  the  essence  of  this  Disease. 

Some  ten  pages  are  consumed  in  considering  the  distribution 
of  the  blood  and  vital  spirits. 

Having  at  the  length  weighed  all  things  which  we  propounded 
concerning  the  causes  which  actuate  and  advance  the  Blood  in  his 
circulation,  it  sufficiently  appeareth,  that  the  circulation  of  the  Blood 
in  this  affect  is  easie  and  expedit  enough,  but  that  it  is  lessened  and 
passeth  dully  thorow  the  parts  first  affected,  both  by  reason  of  the 
sluggishness  of  the  Arterious  Blood  contained  in  the  Artery  of  the  said 
parts,  and  also  because  of  the  defective  heat,  and  slenderness  of  those 
Arteries;  and  finally,  in  regard  of  their  ineffectual  irritation.  And  let 
these  things  suffice  concerning  the  two  former  faults  belonging  to  the 
distribution  of  the  Blood  in  this  affect,  namely,  the  dimunition  and 
slowness  thereof.  It  remaineth  in  the  next  place  to  examine  the  inequality 
of  that  distribution. 

He  gives  a  long  account  of  the  changes  in  the  bones  and  the 
resulting  deformities  which  may,  in  the  main,  be  passed  over.  A 
small  extract  will  serve  to  show  what  this  part  of  the  book  is  like: 


268  PEDIATRICS  OF  THE  PAST 

Moreover,  To  this  Article  we  opportunely  add  the  inflexion  of  some 
of  the  Joynts,  as  of  the  Knees  and  Ankles,  which  happneth  very  fre- 
quently in  this  Disease,  sometimes  being  made  inwardly,  sometimes 
outwardly.  And  this  bending  also  seemeth  to  be  not  unfitly  referred  to 
the  inequality  of  nutrition.  For  if  it  happen  by  unequal  nutrition,  that 
one  side  of  the  Shank-bone  be  so  Iengthned  more  then  the  other:  sup- 
pose outwardly,  that  it  doth  somewhat  lift  up  the  outward  part  of  the 
Epiphysis  of  the  Shank-bone  above  the  inward  part,  the  joynt  in  the  Knee 
must  needs  stand  outwardly  bent;  and  on  the  contrary,  if  the  inward 
part  be  lifted  up,  and  the  outward  depressed,  the  same  Joynt  must  needs 
stand  inwardly  bent. 

He  goes  into  some  detail  concerning  the  deformities  of  the 
chest  and  the  mechanism  of  respiration.  John  Mayow  should  be 
consulted  on  this  point  as  well.  He  concerns  himself  with  the 
question  of  inheritance  of  the  disease: 

These  therefore  are  first  the  soft,  loose  and  effeminate  Constitution 
of  either  or  both  the  Parents,  indisposed  to  strong  and  Masculine  exer- 
cises. Secondly,  an  overmoist  and  full  diet  and  epicurism,  obnoxious  to 
frequent  crudities.  Thirdly,  a  delicate  kind  of  life  abandoned  to  ease 
and  voluptuousness,  slothful,  and  rarely  accustomed  to  labor,  danger 
and  care.  Hither  you  may  also  refer  a  total  defect  of  manly  Exercise, 
immoderate  sleep,  especially  soon  after  meate,  and  any  kind  of  sleepings 
whatsoever,  a  sedentary,  speculative  life,  intent  upon  soft  and  queint 
Arts  and  Sciences,  as  Poetry,  Musick,  and  the  like;  to  these  may  be 
further  added,  a  daily  frequenting  of  Comedies  and  other  Plays,  an 
assiduous  reading  of  Fables  and  Romances,  and  instead  of  manly  and 
laudable  Recreations,  a  loose  expence  of  time  in  Carding  and  Dicing. 
Hitherto  also  belong  the  never  failing  fruits  of  lasting  peace  and  plenty, 
such  as  security,  indiligence  and  the  like. 

Of  the  causes  after  birth  he  considers  air,  meat  and  drink, 
and  things  taken  inwardly. 

Secondly,  Nourishments  that  are  too  thick,  viscous  and  obstructive 
belong  hither,  especially  because  they  interrupt  the  equal  distribution 
of  the  Blood.  Hither  we  refer  flesh  hardned  with  smoke,  and  seasoned 
with  much  Salt;  in  like  manner,  Salt  Fish  and  Cheese,  almost  of  any 
kind  plentifully  fed  on.  Bread  newly  taken  out  of  the  Oven,  and  not  yet 
cold;  also  almost  all  sweet  things  condited  with  Sugar,  unless  they  are 
withall  tempered  with  Wine,  or  cutting  or  attenuant.  Obstructive  Medi- 
cines likewise  of  any  kind  belong  hither,  unto  which  we  may  further  add 
such  as  are  Partotical,  and  whatsoever  being  drank,  induce  a  benummed- 
ness  into  the  parts. 


RACHITIDE 

MORBO  PUERILI, 

TRACTATUS* 

Opera  prima  ac  *Potifiimunt 

Fr  a  nci  sci  Glissomii  Do&oris, 

&  publici  ProfefTorisMedicinsrin  AlmaGwtf*- 
brigu  Academia,  &  Socii  Collegii  Medicoram 

Lendincnfium ,  confcriptut : 

*4dftitis  in  eperit  Sttutatem 
GEORGIO    BATE. 

AHASUERO   RE  CEMORTEIO, 

Medici**  quoqueDo&oribuj,  &  pariterSotiis 
Collegii  Medicorum  Ltmdinenfaim. 

Eclitit  tcrtig,fricrJadcw-*tior/on£e,.&tmadtli*r. 


"~         .CORKELII  DRlEHUYsEN, 
£xOfficina{  & 

FEJ.ICIS   LOPE1    •ty. 


Title  page  of  the  third  edition  of  Glisson's  work  on  rickets. 


27o  PEDIATRICS  OF  THE  PAST 

Thirdly,  Nourishments  that  are  of  an  extream  hot  and  biting  quality, 
sharp  and  corrosive,  as  old  and  strong  Wines,  especially  being  drank 
upon  an  empty  Stomach,  Meats  also  that  are  seasoned  with  much 
Pepper  and  aromatical  Sawces,  must  be  connumerated  among  the  reputed 
causes  of  this  affect:  For  these  things  in  such  a  tender  consistence  of 
the  Parts,  do  easily  feed  upon,  and  devour  the  inherent  Spirits.  The 
same  thing  is  also  affective  by  Medicines  that  are  immoderately  hot  and 
discussive,  yea,  these  are  far  more  powerful  to  hurt,  because  they  more 
quickly  and  forcibly  spoil  the  inherent  Spirits,  than  the  prementioned 
Nourishments. 

Motion,  rest,  exercise  and  actions  are  duly  considered  together 
with  sleeping  and  watching,  and  the  excretions.  The  question  of 
age  is  propounded  and  answered  at  great  length. 

The  Younger  Children  are  more  moist  than  the  elder;  for  to  wax  old, 
if  it  be  taken  in  a  sound  sense,  is  to  wax  dry. 

We  affirm  therefore,  that  this  Disease  doth  very  rarely  invade 
Children  presently  after  their  birth,  or  before  they  are  six  moneths  old; 
(yea,  perhaps  before  the  ninth  moneth)  but  after  that  time  it  beginneth 
by  little  and  little  daily  to  rage  more  and  more  to  the  period  of  eighteen 
moneths,  then  it  attaineth  its  pitch  and  exaltation,  and  as  it  were  resteth 
in  it,  till  the  Child  be  two  years  and  six  months  old:  So  that  the  time 
of  the  thickest  invasion  is  that  whole  year,  which  bears  date  from  the 
eighteenth  month,  two  years  and  a  half  being  expired,  the  Disease  falleth 
into  its  declination,  and  seldom  invadeth  the  Child,  for  the  reasons 
already  alledged. 

Why  children  under  six  months  should  escape  is  puzzling,  and 
Glisson  gives  several  reasons:  the  heat  in  the  womb  and  the 
nurse's  care  protecting  the  child  from  cold;  the  slowness  of  the 
onset  and  the  diet. 

The  Third  Reason  may  perhaps  be  the  wholesomeness  of  the  Diet, 
for  Brest-Milk  is  the  most  salubrious  and  agreeable  nourishment  of  ten- 
der age,  especially  when  it  is  sucked  from  the  Brests:  for  it  is  a  simple  and 
uniform  Meat,  full  of  nourishment,  easie  to  concoct,  and  friendly  & 
familiar  to  the  constitution  of  Infants.  Therefore  so  long  as  they  are 
conveniently  nourished  with  it  they  incur  the  fewer  errors  of  diet,  and 
are  rendred  the  less  obnoxious  to  this  Disease.  Yet  it  must  be  noted, 
that  if  the  Nurses  milk  be  not  laudable  and  good  in  it  self,  or  otherwise 
disagreeable  to  the  Constitution  of  the  Infant,  then  this  reason  is  of  no 
force.  Therefore  if  the  Nurse  be  big  with  Child,  or  immoderately  addicted 
to  Venery,  or  any  wayes  sickly,  or  given  to  drunkenness  and  inordi- 


FRANCIS  GLISSON  271 

nate  feeding,  it  is  safer  to  hasten  the  weaning  of  the  Infant,  unless  you 
are  provided  of  a  better  Nurse. 

The  fourth  and  last  reason  is  the  slowness  of  the  motion  of 
this  Disease  in  his  first  invasions.  For  it  stealeth  on  so  slowly,  that  it 
scarce  bewrayeth  any  preparations  to  an  assault  till  some  moneths  are 
expired,  unless  the  progress  of  it  be  advanced  by  some  extraordinary  and 
most  vehement  Causes,  as  by  some  more  violent  Affect  preceding  from 
it,  preceding  or  coming  upon  it.  Seeing  therefore  that  this  Disease  doth 
so  slowly  take  Root,  and  seeing  that  Children,  as  we  have  formerly  shewed, 
are  commonly  born  free  from  it,  it  seldome  hapneth  to  break  out  evi- 
dently into  act  till  the  sixth,  yea,  indeed  till  the  ninth  moneth.  And 
thus  we  have  given  the  Reasons,  why  Infants  newly  born,  notwithstand- 
ing the  weaknesse  of  their  Constitution,  are  for  many  moneths  privi- 
Iedged  from  this  Disease. 

Secondly,  The  causes  why  Children  from  the  ninth  to  the  eighteenth 
Moneth  are  every  day  more  frequently  infested  with  this  affect,  are  these, 

First,  Because  the  first  Cause  even  now  propounded,  driving  away 
this  Disease  in  those  that  are  new  born,  doth  daily  remit,  and  before  the 
ninth  Moneth  doth  totally  vanish.  Secondly,  In  like  manner  the  second 
propulsive  Cause  before  alledged  till  that  age  doth  every  day  grow  more 
effectual.  For  the  hands  of  Infants  after  some  Moneths,  if  not  before,  are 
usually  set  at  liberty  from  the  Prison  of  their  Blankets,  and  perhaps 
their  Feet  also  before  they  are  six  moneths  old,  although  at  night  they  are 
swadled  up  again.  In  the  day  time  therefore  at  the  least  these  outward 
Members  are  destitute  of  that  common  and  comfortable  warmth.  The 
Nurses  likewise  do  many  times  erre,  when  they  cloath  the  weak  and 
feeble  Infants  too  soon.  For  they  idly  define  the  time  of  cloathing  them 
by  the  number  of  the  Moneths,  seeing  that  they  should  rather  give 
estimation  of  it  by  the  strength  and  activity  of  the  motion  of  their  Hands 
and  Feet.  For  when  the  motion  and  exercise  of  those  parts  doth  avail 
more  to  excite  and  cherish  their  heat,  and  to  irritate  their  Pulses,  then  the 
warmth  of  their  swadling  cloaths,  without  all  controversie  that  is  the 
time  to  devest  Infants  from  their  swadling  cloaths.  Moreover  thirdly, 
After  the  ninth  vloneth  Children  usually  are  fed  with  other  aliment 
besides  Brest-Milk  or  other  Milk,  and  from  that  variety  in  feeding  there 
easily  resulteth  some  errors  in  point  of  Diet.  Fourthly,  The  slowness  of 
the  Motion  of  this  Disease  doth  not  hinder,  but  that  it  may  break  forth 
into  act  after  the  ninth  Moneth.  For  the  motion,  by  reason  of  the  unper- 
ceivable  slowness  of  it,  at  the  end  of  certain  moneths  doth  exhibit  some 
effects  and  impressions.  Lastly,  the  evils  of  breeding  teeth  do  likewise 
contribute  very  much  to  the  same  purpose.  For  the  Teeth  begin  to  breed 
commonly  about  the  seventh  Moneth,  and  come  accompanied  with  divers 
Symptoms,  which  easily  dispose  tender  Bodies  to  this  affect. 


272  PEDIATRICS  OF  THE  PAST 

In  a  number  of  places  Glisson  refers  to  the  frequency  of  the 
disease  in  the  well-to-do  and  its  absence  in  the  poorer  classes. 
The  comparative  absence  of  the  disease  in  Scotland  as  compared 
to  England  he  refers  to  as  follows: 

Fourthly,  therefore  and  lastly,  we  say,  That  the  cause  of  this 
difference  is  the  affluence  of  all  good  things  in  these  Southern  and 
Western  Countries  of  England.  For  this  part  of  the  Kingdom  is  much  the 
more  fruitful,  rich  and  flourishing,  and  abounding  with  all  manner  of 
allurements  to  pleasure.  Therefore  it  is  no  marvail  if  the  customs  of  men 
do  first  degenerate  here,  their  Spirits  decay,  and  the  strength  of  their 
Bodies  begins  to  dissolve :  Now  that  this  degenerate  and  delicate  manner 
of  living  doth  weaken  families,  is  a  truth  so  solidly  and  constantly 
attested  by  Historians,  that  it  were  an  impertinence  to  offer  any  proof 
of  it.  For  you  may  observe  that  the  most  Noble  and  Gallant  Families 
have  been  very  much  reproached  for  these  very  causes;  yea,  and  sooner 
or  later  sometimes  totally  extinguished,  and  so  much  the  sooner  as  they 
have  the  more  refused  to  undergo  labors,  and  to  inure  themselves  to 
masculine  exercises.  Neither  are  families  ever  plunged  in  a  greater 
danger  of  degeneration,  than  when  they  abound  with  all  good  things, 
and  lying  open  to  plenty  and  security  they  are  most  powerfully  invited 
to  delicateness,  idleness  and  effeminateness,  without  any  labour,  care 
and  solicitude.  Who  was  more  rich,  secure,  and  effeminate,  than  Solomon? 
He  left  Rebobam  a  degenerate  Son  behind  him.  And  perhaps  the  family 
of  Henry,  the  8th.  is  extinct  for  the  like  cause.  We  could  heap  up  almost 
innumerable  examples  to  prove  this,  if  it  were  needed.  However  it  be, 
we  see  plainly,  that  this  Disease  doth  more  frequently  and  vehemently 
invade  the  families  of  the  wealthy,  than  the  cottages  of  poor  men,  and 
therefore  it  ought  not  to  seem  strange  that  it  likewise  infested  the  richer 
and  more  pleasanter  parts  of  the  Kingdom ;  namely,  the  South  and  West, 
before  the  North  parts. 

Of  especial  interest  is  the  reference  to  the  association  of  scurvy 
and  rickets.  Barlow,  in  his  classical  article  on  infantile  scurvy, 
with  which  his  name  has  been  associated,  quotes  on  another 
matter  from  Lind's  book  on  scurvy,  the  third  edition  of  which 
appeared  in  1772.  This  is  as  far  back  as  he  got  in  his  references  and 
he  doubtless  did  not  know  the  following  quotation : 

Thirdly,  the  Scurvy  is  sometimes  conjoyned  with  this  Affect.  It  is 
either  hereditary,  or  perhaps  in  so  tender  a  Constitution  contracted  by 
injection,  or  lastly,  it  is  produced  from  the  indiscreet  and  erroneous  Regi- 


FRANCIS  GLISSON  273 

ment  of  the  Infant,  and  chiefly  from  the  inclemency  of  the  Ayr  and  Climate 
where  the  Child  is  educated.  For  it  scarce  holdeth  any  greater  commerce 
with  this  Disease,  then  with  other  Diseases  of  longer  continuance, 
wherein  after  the  same  manner  the  Blood  in  time  contracteth  for  the 
most  part  this  peculiar  infection,  yet  it  must  be  granted,  that  this  Affect 
doth  somewhat  the  more  dispose  to  the  Scurvy  in  regard  of  the  want  of 
motion  and  exercise. 

In  considering  the  disease  a  good  account  of  the  signs  and 
symptoms  is  given.  This  is  one  of  the  few  parts  of  the  book  where 
Glisson  does  not  go  off  into  philosophic  wanderings : 

We  shall  propound  therefore 

First,  the  Signs  which  relate  to  the  Animal  actions. 

Secondly,  Those  which  have  reference  to  the  irregular  Nutrition. 

Thirdly,  Those  that  concern  the  Respiration. 

Fourthly,  Those  that  appertain  to  the  Vital  Influx. 

Fifthly,  Certain  vagabond  and  fugitive  Signs  reducible  to  no  Classis. 
Under  each  of  which  we  shall  subjoyn  the  value  of  the  Signs. 

First  the  Diagnostical  Signs  relating  to  the  Animal  Actions,  are  these. 
The  looseness  and  softness  of  the  parts.  The  debility  and  languidness. 
And  finally,  the  slotbfulness  and  stupif  action. 

First,  A  certain  laxity  and  softness,  if  not  a  flaccidity  of  all  the  first 
affected  parts  is  usually  observed  in  this  affect.  The  Skin  also  is  soft  and 
smooth  to  the  touch,  the  musculous  flesh  is  less  rigid  and  firm;  the  joynts 
are  easily  flexible,  and  many  times  unable  to  sustain  the  body.  Where- 
upon the  Body  being  erected  it  is  bent  forwards  or  backwards,  or  to  the 
right  side  or  to  the  left. 

Secondly,  A  certain  debility,  weakness,  and  enervation  befalleth 
all  the  parts  subservient  to  motion.  This  weakness  dependeth  much 
upon  the  laxity,  softness,  and  Iitherness  of  the  parts  aforesaid:  for  which 
reason  we  have  placed  those  Signs  before  this,  as  also  this  before  the 
slothfulness  and  stupifaction  in  the  next  place  to  be  enumerated,  which 
owe  much  both  to  the  looseness  and  softness.  Moreover,  this  debility 
beginneth  from  the  very  first  rudiments  of  the  Disease.  For  if  Children 
be  infested  within  the  first  year  of  their  age  or  thereabouts,  they  go  upon 
their  feet  later  by  reason  of  that  weakness,  and  for  the  most  part  they 
speak  before  they  walk,  which  amongst  us  English  men,  is  vulgarly 
held  to  be  a  bad  Omen.  But  if  they  be  afflicted  with  this  Disease,  after 
they  have  begun  to  walk,  by  degrees  they  stand  more  and  more  feebly 
upon  their  legs,  and  they  often  stagger  as  they  are  going,  and  stumble 
upon  every  slight  occasion :  neither  are  they  able  to  sustain  themselves 
long  upon  their  legs  without  sitting,  or  to  move  and  play  up  and  down 


274  PEDIATRICS  OF  THE  PAST 

with  an  usual  alacrity,  till  they  have  rested.  Lastly,  upon  a  vehement 
increase  of  the  Disease  they  totally  lose  the  use  of  their  feet;  yea,  they 
can  scarce  sit  with  an  erected  posture,  and  the  weak  and  feeble  Neck 
doth  scarcely,  or  not  at  all  sustain  the  burthen  of  the  Head. 

Thirdly,  a  kind  of  slothfulness  and  numbness  doth  invade  the  Joynts 
presently  after  the  beginning  of  the  Disease,  and  by  little  and  little  is 
increased,  so  that  dayly  they  are  more  and  more  averse  from  motion. 
The  Younger  Children  who  are  carried  about  in  their  Nurses  arms, 
when  they  are  delighted  and  pleased  with  any  thing  do  not  laugh  so 
heartily,  neither  do  they  stir  themselves  with  so  much  vigor,  and  shake 
and  brandish  their  little  Joynts,  as  if  they  were  desirous  to  leap  out  of 
their  Nurses  hands,  also  when  they  are  angred  they  do  not  kick  so  fiercely, 
neither  do  they  cry  with  so  much  fierceness  as  those  who  are  in  health. 
Being  grown  greater,  and  committed  to  their  feet,  they  run  up  and  down 
with  a  wayward  unchearfulness,  they  are  soon  weary,  and  they  love  to 
play  rather  sitting  than  standing,  neither  when  they  sit,  do  they  erect 
their  body  with  vigor,  but  they  bend  it  sometimes  forwards,  sometimes 
backwards,  and  sometimes  on  either  side,  seeking  some  props  to  lean 
upon  that  may  gratifie  their  slothfulness.  They  are  not  delighted  like 
other  Children  with  the  agitation  of  their  bodies,  or  any  violent  motion; 
yea,  when  the  Disease  prevaileth  they  are  averse  from  all  motion  of 
their  limbs;  crying  as  they  are  at  any  play  that  is  never  so  little  vehement; 
and  being  pleased  again  with  gentle  usage  and  quiet  rest.  In  the  interim, 
unless  some  other  disease,  Symptom,  or  cause  of  sickness  doth  come 
between,  they  are  moderate  in  sleeping  and  waking,  they  are  ingenious, 
not  stupid,  but  for  the  most  part  of  forward  wits,  unless  some  other 
impediments  arise,  their  countenances  are  much  more  composed  and 
severe  than  their  age  requireth,  as  if  they  were  intent  and  ruminating 
upon  some  serious  matter. 

These  Signs  being  taken  together,  unless  they  result  from  some 
evident  wariness,  or  proceed  from  some  primary  affect  of  the  Brain 
(which  indeed  happeneth  very  seldom  in  this  tenderness  of  age)  do  con- 
stitute a  sufficient  Patbognomonical  Syndrom  of  the  first  kind,  and  where 
they  are  present  together,  they  certainly  witness  the  presence  of  the 
Disease,  and  when  they  are  absent  together  they  infallibly  attest  the 
Essence  of  this  Disease.  But  if  at  any  time  a  wearisomeness  do  bewray 
any  Feaverish,  or  other  like  Signs,  they  may  easily  be  distinguished  from 
these,  both  because  the  reasons  of  the  weariness  have  gone  before,  and 
also  because  the  Signs  from  thence  arising  do  suddenly  break  out,  and  as 
soon  vanish.  But  in  this  affect  the  signs  do  invade  by  degress,  and 
persevere,  or  else  they  are  daily  more  encreased.  Now  the  primary 
Diseases  of  the  Brain  are  distinguished  by  their  proper  Signs.  And  thus 
much  of  the  Signs  which  relate  to  the  Animal  Actions. 


FRANCIS  GLISSON  275 

THE   SIGNS  WHICH  BELONG  TO  THE  DISPROPORTIONED   NOURISH- 
MENT OF  THE   PARTS 

Of  how  great  moment  the  Alogotrophy,  or  unequal  Nourishment  of  the 
Parts  in  this  affect,  we  have  already  shewed;  we  shall  here  therefore 
prosecute  those  signs  which  in  some  great  measure  depend  upon  it,  and 
we  shall  present  them  as  if  they  were  to  be  beheld  at  one  View. 

First,  there  appeareth  the  unusual  bigness  of  the  Head,  and  the  ful- 
ness and  lively  complexion  of  the  Face,  compared  with  the  other  parts  of 
the  Body.  But  although  this  Sign  may  presuppose  some  motion  of  the 
Disease  before  it  shine  out,  yet  is  the  Disease  so  obscure  before  the 
appearance  of  it,  that  it  is  accounted  in  a  manner  unperceivable:  There- 
fore commonly  this  Sign  sheweth  it  self  more  or  less  from  the  first  begin- 
ning, and  continueth  till  the  departure  of  the  affect,  unless  (as  we  have 
noted  before)  the  pining  of  those  parts  supervene  from  some  other  cause. 

Secondly,  the  fleshy  parts,  especially  those  which  are  full  of  muscles 
beneath  the  Head  which  we  have  listed  among  the  first  affected,  in  the 
progress  of  the  Disease  are  daily  more  and  more  worn  away,  made  thin 
and  lean.  This  Sign  doth  not  presently  shew  it  self  from  the  beginning  of 
the  Disease,  because  it  pre-requireth  some  notable  motion  of  the  Disease 
before  it  evidently  appeareth;  yet  in  time  most  certainly  is  exposed  to 
the  senses,  and  accompanieth  the  Disease  to  the  last  step  be  it  either  to 
life  or  death;  excellently  demonstrating  the  motion  and  degree  of  the 
Disease  by  its  encrease.  Moreover  this  Sign  being  conjoyned  with  the 
former  doth  at  least  constitute  a  Patbognomonical  Sign  of  the  second 
kind,  that  is  such  an  one  as  is  proper  to  this  Disease  alone;  and  where 
they  are  present  together  they  infallibly  denote  the  presence  of  this 
Disease,  although  upon  their  absence  they  do  not  equally  signifie  the 
absence  of  the  Disease. 

Thirdly,  Certain  swellings  and  knotty  excrescences,  about  some  of  the 
joynts  are  observed  in  this  affect;  these  are  chiefly  conspicuous  in 
the  Wrists,  and  somewhat  less  in  the  Ankles.  The  like  Tumors  also  are  in 
the  tops  of  the  Ribs  where  they  are  conjoyned  with  gristles  in  the  Breast. 
We  have  noted  above  in  our  Anatomical  Observations  that  these  tumors 
are  not  scituated  in  the  Parts,  but  in  the  very  bones;  although  this  con- 
sideration doth  scarce  belong  to  them  as  Signs,  seeing  that  of  themselves 
they  are  scarce  conspicuous.  This  Sign  doth  also  suppose  some  kind  of 
motion  of  the  Disease,  neither  is  it  emergent  a  Principio  principiante,  as 
the  Philosophers  phrase  it,  yet  of  offers  it  self  as  an  object  to  the  senses 
sooner  than  any  considerable  extenuation  of  the  parts.  But  where  it  is 
present,  it  constitutes  a  Patbognomonical  Sign  of  the  Second  kind,  and 
without  dispute  witnesseth  the  Species  of  the  Disease. 

Fourthly,  Some  Bones  wax  crooked,  especially  the  Bones  called  the 
Shank-bone,  and  the  Fibula  or  the  small  Bone  in  the  Leg,  then  afterwards 


276 


PEDIATRICS  OF  THE  PAST 


the  greater  Shank-bone,  and  the  undermost  and  lesser  of  the  two  long 
Bones  of  the  Elbow,  but  not  so  much  altogether  nor  so  often;  sometimes 
also  the  Thigh-bone  and  the  Shoulder-bone.  Again,  there  is  sometimes 
observed  a  certain  shortning  of  the  Bones  and  a  defective  growth  of 
them  in  respect  of  their  longitude.  This  by  chance  was  omitted  above, 
where  we  gave  the  Reason  of  the  Organical  faults.  Yet  this  affect  doth 


44  DeRdcbitute. 

oftitrai  ab  coram  fiexibilitttc  procedure 
non  exiftimo;  cum  pucris  morbo  hoc  affli- 
€tis »  majora  potius  &  firmiora  fint  ofla, 
quam  in  aliis:  uti  mox  videbimus:  Cumta- 
mennotabtlis  adco  fithzc  offium  incurvi- 
tas;  lie  cat  dc  eadcm  inquirenda  pauloefle 
prolix  ioremr  Etprimo  DoSHflimi  GlifonU 
opinionem,  dcin  noftram  brcvitcr  profe- 


ram. 


'Comparemus  inquit  V%r  CUrijf:  ofia, 
*qu  i  bu  s  curvitas  accidere  folet  columnar,  8c 
'certc  fatis  appofite ,  cum  fi  trigantur  co- 
*lumnam  quodammodo  refcrunt;  atque  in- 
*de  demonltrattonem  rem  banc  cxplican- 
•tcm  deducimus:  efto  ergo  columna  tr ibus 
•lapidibus.  A.  B.  C.  fibi  in  vicem  impofitis, 
♦exftnldb:  Tdb,  i.Fig.  1.  fupponimus  ta- 
flcm,  quae  ab  omni  latere  perpendiculariter 
'fit  ereda,  ejufdemoue  altitudinis:  ft  ergo  \ 
dextro  latere  immiicris  caneum  Inter lapi- 
des  A.  B.  per  lineam  F.  D.  neceflario  caput 
columnar,  fupremus  nempc  lapis  inclinable 
tur  verfus  D.  angulumque  in  D.  efficiet,  & 
altttudo  columns  a  dextris  erit  clatior 
cuam  1  finiftris;  ft  militer  11  alteram  Impute* 
nscuneum  per  lineam  G.  E.  inter  lapides 
B.  C.  amplius  adhuc  inclinabitur  columna, 
fietque  augulus  in  E.  ftat  ergo  jam  columna 
inclinata  ad  larvam,  in  bunc  modum  A.B.C. 
— F.  G.  I>.  E.  Fig.  i .    Quo  autcm  ex  plu* 

nbu> 

A  page  from  Glisson's  "De  Rachitide"  showing  an  illustration. 


seem  to  depend  upon  the  same  irregular  nourishment;  namely  so  far  forth 
as  the  nourishment  taken  in  encreaseth  the  Bones  according  to  breadth 
and  thickness  more  than  length.  From  hence  it  comes  to  pass  that  some 
Children  long  afflicted  with  this  Disease  become  Dwarfs.  Hither  perhaps 
may  be  referred  that  folding  in  the  Wrists,  the  Skin  it  may  be  having 
better  nourishment  and  more  growth  than  the  Bones  of  those  parts, 
whereupon  it  must  needs  be  contracted  in  the  Wrists  into  a  folding  or 
wrinkledness.  Finally,  to  this  place  also  may  belong  a  certain  sticking 
out  of  the  Bones  of  the  Head,  especially  of  the  Bone  of  the  forehead 


FRANCIS  GLISSON  277 

forwards.  For  it  concerneth  the  common  kind  of  vitiated  Figure  and  the 
Alogotrophy  of  the  Bones.  Yet  this  in  the  Bone  of  the  Forehead  doth 
evidently  seem  to  depend  upon  the  free  nourishment  of  that  Bone  in  his 
circumference,  wherewith  it  is  coupled  to  the  Bones  of  the  fore  part  of 
the  Head,  and  constitutes  that  seam  called  Sutura  Coronalis,  which  Iieth 
in  the  foremost  parts  thereof.  For  hereupon  it  must  needs  be  thrust 
forwards.  And  indeed  in  that  place  it  is  plentifully  nourished  without  any 
difficulty,  because  this  Bone  in  Children  is  cartilaginous  towards  that 
Seam.  And  this  also  was  pretermitted  above  where  we  discoursed  of  the 
Organical  faultiness,  because  we  have  but  lately  observed  it. 

Fifthly,  The  Teeth  come  forth  both  slowly  and  with  trouble,  they 
grow  loose  upon  every  slight  occasion,  sometimes  they  wax  black,  and 
even  fall  out  by  pieces.  In  their  stead  new  ones  come  again  though  late 
and  with  much  pain.  This  kind  of  Sign,  as  also  that  which  we  noted  in 
the  former  Article,  may  be  referred  to  the  Synedremontal  Signs,  because 
neither  of  these  is  either  perpetually  present,  or  if  it  be  present,  it  doth 
not  undoubtedly  confirm  the  presence  of  the  Disease. 

Some  have  imagined  that  the  Bones  in  this  Disease  are  transfigurable 
like  wax;  But  we  have  never  seen  it,  neither  have  we  received  it  from  any 
eye  witness  who  was  not  of  suspected  credit.  Wherefore  we  reject  this 
Sign  as  altogether  Fabulous. 

Sixthly,  The  Breast  in  the  higher  progression  of  the  Disease,  becomes 
narrow  on  the  sides,  and  sticking  up  foreright,  so  that  it  may  not  be 
unaptly  compared  to  the  Keel  of  a  Ship  inverted,  or  the  Breast  of  a  Hen 
or  Capon.  For  on  each  side  of  the  middle  it  riseth  up  into  a  point,  the 
sides  being  as  it  were  pressed  down.  If  any  demand  whether  this  Sign  be 
solely  appropriated  and  peculiar  to  this  affect;  We  answer,  That  the 
Breast  may  be  a  little  encreased  in  an  Atrophy  or  Phtisick,  and  less 
than  the  other  parts  of  the  Body,  and  so  by  consequence  it  may  be  nar- 
rower: But  it  can  scarce  so  fall  out  according  to  the  change  of  the  Figure 
without  an  Alogotrophy ,  namely  that  which  is  proper  to  this  Disease. 
Wherefore  this  Sign  also  when  it  is  present,  although  the  invasion  of  it 
be  tardy  must  be  reputed  a  Patbognomonical  Sign  of  the  second  kind, 
because  when  it  is  present,  it  certainly  denoteth  the  Species  of  the 
Disease,  though  not  on  the  contrary.  And  thus  much  of  the  Signs  which 
have  reference  to  the  unequal  nourishment. 

THE  SIGNS  WHICH  BELONG  TO  RESPIRATION 

First,  the  narrowness  and  sticking  up  of  the  Breast  already  mentioned 
must  be  hither  referred;  whereof  we  then  discoursed  at  large. 

Secondly,  A  swelling  of  the  Abdomen,  and  an  extension  of  the  Hypo- 
chondriacal parts,  which  hindreth  free  motion  of  the  Diaphragm  down- 
wards, and  by  consequence  doth  somewhat  interrupt  the  breathing. 


278  PEDIATRICS  OF  THE  PAST 

Yet  it  must  be  noted  that  the  Abdomen  and  the  Hypocbondries  also  in 
respect  of  their  outward  parts  appear  very  lean  and  extenuated,  but 
inwardly,  namely  in  those  parts  which  are  contained  in  the  Cavity  of 
the  Abdomen,  they  swell;  from  whence  ariseth  this  fulness.  This  swelling 
proceedeth  partly  from  the  windiness  of  the  Stomach  and  Guts,  and 
partly  from  the  bigness  of  the  Liver  and  other  Bowels.  Sometimes  also  a 
watry  moisture  into  the  Cavity  of  the  Abdomen,  introducing  an  Ascites, 
joyneth  in  this  conspiracy.  This  Sign  is  seldome  absent,  and  yet  it  must 
be  numbred  among  the  Patbognomonical  Signs,  because  it  is  common  to 
many  other  Diseases. 

Thirdly,  A  Cough  is  frequently  present  in  this  Affect,  as  also  a 
difficulty  of  breathing,  and  many  other  faults  of  the  Lungs,  as  Stoppings, 
hard  Tumors,  Imposthumes,  Inflammations,  a  Coalescence  of  them  with 
the  Plura,  and  the  like;  Yet  these  scarce  deserve  to  be  reckoned  among 
Signs,  because  of  themselves  (whilst  the  Patient  Iiveth)  they  are  not 
sufficiently  conspicuous. 

Fourthly,  Children  afflicted  with  this  Disease  are  averse  from  lying 
upon  their  Sides  either  the  right  or  the  left,  or,  at  least  it  is  troublesom 
to  them ;  namely,  either  because  of  the  Coalescence  of  the  Lungs  with 
the  Plura,  or  by  reason  of  some  Tumor  on  the  contrary  side,  but  to  lye 
with  their  Faces  upwards  they  are  very  much  delighted.  And  these  signs 
also  being  taken  together  will  not  amount  to  Patbognomonical  signs  of 
either  kind,  but  Synedremontal  only  and  are  common  to  other  Diseases. 

SIGNS  BELONGING  TO  THE  VITAL  INFLUX 

First,  the  Veins  and  the  Arteries  are  more  slender  than  ordinary  in 
the  first  affected  parts,  and  less  conspicuous  than  you  would  expect  in  a 
lean  Body.  But  in  the  Face  (respect  being  had  to  the  gracility  aforesaid 
in  the  other  part)  they  exceed  the  just  proportion.  This  perhaps  is  a 
Patbognomonical  sign,  although  it  be  difficult  to  be  observed,  and  indeed 
not  yet  sufficiently  sifted  by  us. 

Secondly,  The  Pulse  in  the  Wrists,  and  the  other  affected  parts  is 
small  and  weak,  otherwise  perhaps  it  is  moderate,  unless  when  a  Feaver 
is  present. 

Thirdly,  A  moderate  Ligature  cast  about  the  Elbow  or  the  Knee, 
doth  not  so  soon  swell  and  color  the  part  beneath  and  above  the  Liga- 
ture with  Blood,  as  it  doth  in  other  sound  Children  of  the  same  age. 

CERTAIN  VAGABOND  AND  WANDRING  SIGNS 

First,  An  appetite  to  Meat  and  Drink  that  is  either  moderate,  or 
unduely  weak,  unless  where  a  Feaver  is  conjoyned. 

Secondly,  the  Excrements  of  the  Belly  and  Bladder  do  commonly 
resemble  theirs  that  are  in  health,  unless  some  other  Disease  interdict  it. 


FRANCIS  GLISSON  279 

Thirdly;  It  is  observed,  that  those  which  are  sick  of  this  disease  do 
abominate  sweet  things,  as  Syrups,  and  Junkets  condited  with  much 
Sugar  or  Honey;  Perhaps  also  such  things  as  these  are  hurtful  for  them, 
as  also  for  those  which  are  troubled  with  the  Scurvy,  because  they 
thicken  the  humors. 

Fourthly,  Some  have  observed,  That  they  have  seen  some  Children 
affected  with  the  Racbites,  to  weigh  heavier  than  others  of  the  same  age 
and  stature.  If  this  be  so,  it  must  be  attributed  partly  to  the  facility,  and 
partly  to  the  inequality  of  the  Nutrition  of  the  bony  substance  in  this 
Affect.  For  when  this  weight  can  scarce  be  ascribed  to  the  Flesh,  which 
are  here  extenuated,  it  seemeth  plain  that  this  must  be  attributed  to  the 
bony  substance:  And  seeing  that  the  Bones  in  this  Disease  are  not  yet 
observed  to  encrease  beyond  measure  in  respect  of  their  longitude,  it 
followeth  plainly,  that  it  must  be  imputed  to  the  thickness  of  them  which 
is  superfluously  augmented.  These  are  also  common  signs,  neither  do  they 
merit  a  more  worthy  estimation.  And  thus  much  for  the  Diagnostical 
Signs,  the  Diacritical  now  follow. 

Compare  the  description  of  early  rickets  with  any  of  the 
modern  textbooks  and  note  how  thorough  an  observer  our  author 
was.  In  doing  so  one  must  bear  in  mind  that,  excepting  Whistler's 
poor  thesis,  this  was  the  first  description  of  the  disease. 


THE    SIGNS    OF   THE    PRESENT   DISEASE    OF    THE    RACHITES    NEWLY 

BEGUN 

First,  Diligent  Observation  must  be  employed  about  the  three  kinds  oj 
Signs  ascribed  above  to  the  Animal  Actions;  namely,  the  looseness  and 
softness  of  the  parts,  the  weakness  and  Ianguidness,  the  slothfulness  and 
numness.  For  these  do  in  a  remiss  degree,  and  sub-obscurely  yield 
advantage  to  circumspection  and  heedfulness  presently  a  principio 
prirtcipiant,  as  they  phrase  it. 

Secondly,  The  colour  must  be  considered,  and  the  habit  of  the  Head  and 
Face  in  relation  to  the  Joynts.  For  if  the  colour  or  the  habit  be  more 
fresh  and  lively  in  those  than  in  these,  it  presenteth  a  strong  suspition 
that  this  Disease  hath  taken  root.  For  although  the  Bulk  of  the  Head 
which  is  evidently  encreased,  and  also  the  extenuation  of  the  parts 
affected  do  pre-require  some  considerable  motion  and  duration  of  the 
Disease  before  they  appear,  yet  from  the  beginning  a  certain  difference 
may  be  observed  by  an  accurate  attention  or  intuition  in  respect  of  the 
heat  and  the  habit  of  these  parts  compared  one  with  another. 

Thirdly,  The  Wrists  and  the  extremities  oj  the  Ribs  must  be  noted.  For 
before  the  end  of  the  beginning  certain  rudiments  of  knurls  or  knots 


280  PEDIATRICS  OF  THE  PAST 

begin  to  appear  in  the  Wrists,  and  Excrescencies  also  in  the  tops  of  the 
Ribs. 

Fourthly,  A  kind  of  swelled  fulness  and  stretching  the  Belly  is  conspicu- 
ous immediately  after  the  beginning,  especially  in  the  Hypochondriacal 
parts.  For  the  magnitude  of  the  Belly  compared  with  the  magnitude  of 
the  Brest  exceeds  the  just  and  due  proportion. 

Now  these  Signs  collectively  taken  do  assuredly  demonstrate  the 
presence  of  the  Disease  even  from  the  very  beginning.  But  if  no  sensible 
and  manifest  extenuation  of  the  first  affected  parts  do  appear  at  the  same 
time,  in  that  very  respect  it  is  cleerly  distinguished  from  the  encrease 
thereof. 

Of  great  value  too,  are  the  observations  on  the  association  of 
other  diseases  with  rickets. 

Lastly,  Some  differences  happen  to  this  Disease  by  reason  of  other 
Diseases,  wherewith  they  are  peradventure  complicated;  in  which  case, 
besides  the  Diagnostical  Signs  already  reckoned,  some  other  may  be 
desired  as  peculiarly  proper  to  the  complicated  Disease.  Nevertheless 
an  accurate  Description  of  them  cannot  be  here  expected,  because  for  the 
most  part  they  are  the  same  which  are  every  where  attributed  to  those 
Diseases  by  practical  Writers.  But  because  some  Diseases  do  more 
frequently  accompany  this  than  others,  we  will  briefly  look  into  their 
Signs. 

First,  therefore  a  Hydrocephalus  or  Dropsie  in  the  Head  being  com- 
plicated with  this  Affect  needeth  sometimes  no  Signs  to  make  it  known, 
but  is  sufficiently,  yea  abundantly  manifest  of  it  self:  namely,  either  by 
the  exceeding  magnitude  of  the  head,  or  by  the  Water  that  is  outwardly  con- 
tained under  the  Pericranium  (which  notwithstanding  we  suppose  doth 
very  rarely  happen)  or  by  some  extreme  opening  and  wideness  of  the  seams 
in  the  Head,  Water  having  gotten  into  them,  and  lifting  up  the  Dura  Mater, 
so  that  a  soft  and  waterish  tumour  is  outwardly  perceivable  by  the  touch  in 
the  spaces  between  the  Bones.  Many  times  the  Hydrocephalus  is  somewhat 
obscure  and  requireth  Signs  to  discover  it.  First,  Therefore  all  the  inward 
and  outward  senses  are  more  dull  than  otherwise  they  use  to  be  in  this  affect. 
Secondly,  The  magnitude  of  the  Head  is  sometimes  greater  than  at  other 
times.  Thirdly,  The  Sutures,  or  seams  in  the  accustomed  places  do  gape 
more  wide,  and  are  closed  again  more  slowly  than  they  are  wont  to  be. 
Fourthly,  The  Bone  in  the  Forehead  is  more  outwardly  sticking  out,  and  in 
the  other  Bones  of  the  Head  you  may  observe  certain  inequalities  and  bunch- 
ings  out  of  an  unusual  bigness. 

Secondly,  The  conjoyned  evils  of  breeding  Teeth  are  thus  known,  i. 
//  the  accustomed  time  of  breeding  Teeth  be  either  approching,  or  now  at 
hand;  for  from  hence  ariseth  some  suspition  of  pain  from  thence  proceed- 


FRANCIS  GLISSON  281 

ing.  This  time  ordinarily  beginneth  in  the  seventh  month  after  the  birth, 
and  continueth  till  the  Child  be  a  year  and  six  months  old,  and  longer,  if 
the  Teeth  come  slowly;  which  hapneth  very  commonly  in  this  affect; 
and  it  endeth  when  the  number  of  the  Teeth  is  complete.  2.  Children  to 
mitigate  the  raging  pain  do  use  to  put  their  Fingers  in  their  Mouths,  accord- 
ing to  that  old  saying,  ubi  dolor,  ibi  digitus.  3.  The  Gums  wax  white  on  that 
side  where  the  Tooth  is  to  break  out,  and  are  somewhat  hot  in  the  touch.  4. 
The  Teeth  that  come  forth  sometimes  wax  black  or  are  loose,  or  jail  out  by 
pieces.  5.  To  these  you  may  add  watcbings,  the  looseness  of  the  Belly,  Feavers 
and  Convulsions,  which  notwithstanding  are  chanceable  Symptomes. 

Thirdly,  An  Asthma  is  perceived  by  the  very  difficulty  oj  breathing, 
when  it  doth  not  proceed  from  the  stretching  and  fulness  of  the  lowest 
Belly.  But  if  withall  there  be  a  swelling  or  Impostbume,  and  that  in  either 
side  oj  the  Lungs,  they  can  scarce  endure  to  lie  on  the  contrary  side;  but  if  it 
be  on  both  sides,  then  they  desire  to  lie  erect  or  with  their  Faces  upwards. 
The  same  thing  for  the  most  part  hapneth  in  an  Inflammation,  with  a 
growing  together  oj  the  Lungs  with  the  Pleura,  as  also  in  a  Pleurisie,  but 
then  there  are  added,  an  acute  Feaver,  Cough  and  spitting  oj  Bloud,  moreover 
in  a  Pleurisie  a  pricking  pain  in  the  side.  The  Ptisick  is  known  by  a 
diuturnal  Cough,  and  a  roundish  and  sometimes  a  purulent  spittle  (although 
indeed  Children  do  seldom  spit  out,  because  that  matter  which  the  Cough 
fetches  up  into  the  Mouth  they  swallow  by  the  Oesophagus)  also  by  a 
putrid  Feaver  conjoyned,  and  by  a  sudden  Colliquation  in  the  parts.  An 
Ascites  is  discovered  by  the  unreasonable  bigness  oj  the  Abdomen. 

Fourthly,  A  Hectick  Feaver  bewrayeth  itself  by  a  continual  beat, 
being  somewhat  more  vehement  than  that  in  a  Quotidian  Ague  especially 
about  the  Arteries,  and  still  encreasetb  ajter  the  receiving  oj  meat;  also  by 
the  swijt  and  speedy  consumption  oj  the  parts:  a  putrid  Feaver  is  known  by 
the  urin  being  at  the  beginning  crude,  ajterwards  more  concocted,  then  also 
from  the  extream  high  colour  oj  it.  Moreover,  if  it  be  an  intermitting  Ague, 
it  is  discernible  by  the  inequality  oj  the  beat,  the  external  parts  being  at 
the  beginning  extream  cold,  and  ajterwards  excessive  hot;  also  jrom  the 
jits  either  constant  or  erratical;  again,  by  the  contraction  oj  the  Pulse,  upon 
the  approach  oj  the  jit,  ajterwards  unduly  encreased.  A  continual  Feaver 
is  known  by  an  intensive  and  un-remitting  heat,  also  by  thirst,  roughness 
oj  the  Mouth,  and  the  altered  colour  oj  the  tongue,  and  the  like. 

Fifthly,  The  Venerous  Pox  is  supposed  to  meet  in  complication,  ij 
either  oj  the  Parents  or  the  Nurse  were  bejore  injected;  ij  any  Ulcers  appear 
in  the  Head,  Mouth  and  Nostrils;  or  ij  any  eminent  and  crusted  Wheals 
break  out,  especially  such  as  ordinary  Medicines  cannot  subdue:  ij  bard 
tumors  grow  conspicuous,  or  knots  dejiling  the  Bones  in  the  Fingers  with 
rottenness,  or  any  other  parts;  ij  unquietness  and  bitter  pains  in  the  night- 
time alarum  the  sick;  or  ij  Bubons  break  out  in  the  Groyn. 


282  PEDIATRICS  OF  THE  PAST 

Sixthly,  The  Scurvy  complicated  with  this  affect  hath  these  signs: 

1.  They  that  labour  under  this  affect  do  impatiently  indure  Purgations; 
but  they  who  had  only  affected  with  the  Rachites  do  easily  tolerate  the  same, 

2.  They  are  much  offended  with  violent  exercises,  neither  can  they  at  all 
endure  them.  But  although  in  this  affect  alone,  there  be  a  kind  of  slothful- 
ness  and  aversation  from  exercise,  yet  exercise  doth  not  so  manifestly, 
at  least  not  altogether  so  manifestly  hurt  them,  as  when  the  Scurvy 
is  conjoyned  with  the  Racbites.  3.  Upon  any  concitated  and  vehement 
motion  they  draw  not  breath  without  much  difficulty,  they  are  vexed  with 
diverse  pains  running  through  their  Joynts,  and  these  they  give  warning 
of  by  theyr  crying,  the  motion  0/  the  Pulse  is  frequent  and  unequal,  and 
sometimes  they  are  troubled  with  a  Palpitation  of  the  Heart,  or  tbreatned 
with  a  Lypotbymis,  which  Affects  are  for  the  most  part  soon  mitigated,  or 
altogether  appeased  by  laying  them  down  to  rest.  4.  Tumours  do  very 
commonly  appear  in  the  Gums.  5.  The  Urin  upon  the  absence  of  the  accus- 
tomed Feaver  is  much  more  intense  and  encreased. 

Seventhly,  The  Strumatical  Affect,  if  extremely  complicated  with  the 
Racbites,  is  sufficiently  conspicuous  by  Swellings  obvious  to  the  senses; 
yea,  where  many  knotty  Excrescences  do  outwardly  occurr,  it  may  be 
justly  suspected  that  the  like  Tumors  do  lurk  in  the  Bowels.  But  if  the 
knots  grow  inwardly  only,  they  are  scarce  discernable  by  an  certain  sign; 
for  that  Rule  which  some  have  observed,  namly,  That  those  which  have 
short  Necks,  low  and  narrow  Foreheads,  with  compressed  Temples,  and 
wide  Cheek-bones,  are  subject  to  these  strumatical  Tumors  and  Excres- 
cencies,  is  too  uncertain  and  fallible;  Others  affirm,  That  Purging 
Medicines  taken  otherwise  in  a  just  proportion  will  scarce  work  with 
those  who  are  thus  affected;  but  we  answer  from  our  own  Experience 
That  it  is  sometimes  only,  and  not  always  true.  Thus  much  of  the  signs 
of  the  differences. 

This  is  not  the  place  to  go  into  Glisson's  ideas  on  treatment. 
For  the  most  part  his  therapy  is  that  of  the  period.  He  considers 
"Indications  preservative"  and  has  much  to  say  of  "Cacochym- 
ical"  humors.  He  also  considers  the  "Indications  conservative 
or  vital."  His  remarks  about  scarification  of  the  ear  and  the 
reasons  therefore;  the  way  the  spinal  marrow  is  affected  by  this 
procedure,  would  bring  joy  to  the  heart  of  an  osteopath  or  chiro- 
practor. But  Glisson  relegates  this  procedure  to  the  background 
and  scores  the  Empirics  for  making  so  much  of  it.  Issues,  cupping, 
leeches,  blisters  and  the  use  of  ligatures  are  all  taken  up.  This  last 
is  the  Bier  treatment  also  commented  on  in  considering  Mayow's 
treatise. 


FRANCIS  GLISSON  283 

Fourthly,  Ligatures  also  may  be  referred  to  this  Title,  and  indeed 
we  grant,  that  sometimes  they  are  not  altogether  unuseful  in  this  affect; 
namely,  if  they  be  very  moderate,  and  adhibited  by  just  distances,  and 
unto  convenient  places;  but  you  must  beware  that  they  hinder  not  the 
growth  of  that  part,  whereunto  they  are  applyed;  which  is  done  if  they 
be  sufficiently  loose,  and  made  of  soft  wooll,  if  in  the  Day-time,  or  for 
some  part  of  the  Day  they  are  tyed  up,  and  unbound  at  night,  if  they 
be  fitted  to  the  Thighs  and  Legs  upon  the  Knee,  and  to  the  Arms  upon 
the  Elbow. 

Yet  Ligatures  do  here  seem  to  conduce  much  to  the  stoppage  of  the 
Blood  from  flowing  to  the  Head,  and  that  it  ought  to  be  fastned  to  the 
outward  parts  that  are  extenuated:  besides,  this  Remedy  is  good  to 
retard  the  over  slippery  return  of  the  Blood  in  those  parts,  unto  which 
the  Ligature  is  applyed. 

The  use  of  swathing  and  splints  is  duly  described,  followed 
by  a  chapter  on  laxatives  and  vomits,  and  another  on  simples 
and  compounds.  He  devotes  a  chapter  to  "specifical  alterant 
medicines,,,  which  term  would  make  a  good  name  for  a  patent 
medicine.  He  explains  symptomatic  treatment.  Most  important 
of  all  in  the  line  of  treatment  is  the  portion  of  the  book  about 
external  remedies,  several  quotations  from  which  follow: 

Lastly,  lying  down,  if  you  observe  a  right  way  of  placing  and  making 
the  Bed,  may  contribute  very  much  to  correct  the  Crookning  of  the  Back- 
bone and  the  whole  Body,  for  when  they  lie  upon  the  gibbous  and 
bunched  Side,  a  little  bag  made  for  the  same  purpose  may  be  laid  under 
the  parts  sticking  out,  and  so  made  fit  that  the  gibbous  part  may  in  a 
manner  sustain  the  weight  of  the  whole  Body,  and  so  they  may  be  com- 
pelled as  it  were  to  a  straightness.  But  when  Children  roul  to  the  other 
side,  the  Bed  should  be  so  made,  that  if  the  little  Pillow  or  Bay  be  taken 
away  the  hollow  part  should  scarce  touch  the  Bed  unless  he  conform  him- 
self to  a  straight  line,  that  by  his  weight  it  may  be  depressed  to  a 
straightness. 

Thirdly,  The  bearing  them  about  in  the  Nurses  Arms  is  almost  agree- 
able to  the  same  Children,  and  under  the  same  conditions:  in  like  manner  the 
rejoycing  of  the  Child  whilst  the  Nurse  singeth,  either  as  it  sits  in  her 
Lap,  or  is  held  up  in  her  Hands,  as  also  the  tossing  of  it  up  and  down, 
and  waving  of  it  to  and  fro,  and  if  the  Child  be  strong  by  holding  it 
gently  up  by  the  Hands,  if  it  be  weak,  under  the  Arms,  yet  so  that  the 
Thighs  and  the  whole  Body  may  hang  down.  Also  the  drawing  of  the 
Children  backward  and  forward  upon  a  Bed  or  a  Table  between  two 
Nurses,  the  one  holding  it  by  a  Hand,  the  other  by  a  Foot.  The  two  last 
motions  seem  to  contribute  somewhat  to  the  erection  of  the  crooked  or 


284  PEDIATRICS  OF  THE  PAST 

bended  Back-bone,  especially  if  the  Hand  which  is  laid  upon  the  depressed 
Shoulder,  and  the  Foot  which  is  belonging  to  the  elevated  Hip  be 
drawn  with  more  strength  and  vehemence  than  the  other  hand  or  foot. 
To  the  same  end  also  tendeth  the  lifting  up  of  the  Child,  taking  him  by 
his  Feet  only,  so  that  the  trunk  of  his  Body  and  his  Head  may  for  a 
time  hand  down  in  an  inverted  posture;  although  indeed  this  action  may 
also  seem  in  some  manner  to  relate  unto  the  growing  of  the  Liver,  if  any 
such  at  that  time  be:  as  also  that  convolution  of  the  Body,  whereby  the 
Head  Being  lowermost  the  Feet  are  lifted  up;  and  then  again  the  Head 
being  lifted  up  the  whole  Body  is  inverted.  Hitherto  also  may  be  referred 
that  rouling  of  the  Child,  which  some  use  upon  a  Bed  or  Table,  the  Body 
being  laterally  declined:  which  we  more  approve  if  it  be  not  rouled  quite 
round  about,  but  only  backwards,  laying  a  little  hard  Cushion  under- 
neath, whereon  the  gibbous  part  may  rest,  and  sustain  the  weight  of  the 
Body.  This  exercise  being  rightly  practised  doth  help  much  to  straighten 
the  Body. 

The  artificial  suspension  of  the  Body  is  performed  by  the  help  of  an 
instrument  cunningly  made  with  Swathing  Bands,  first  crossing  the 
Brest  and  coming  under  the  Armpits,  then  about  the  Head  and  under 
the  Chin,  and  then  receiving  the  hands  by  two  handles,  so  that  it  is  a 
pleasure  to  see  the  Child  hanging  pendulous  in  the  Air,  and  moved  to  and 
fro  by  the  Spectators.  This  kind  of  Exercise  is  thought  to  be  many 
waies  conducible  in  this  Affect,  for  it  helpeth  to  restore  the  crooked 
Bones,  to  erect  the  bended  Joynts,  and  to  lengthen  the  short  Stature  of 
the  Body.  Moreover,  it  exciteth  the  vital  Heat,  and  withall  allureth  a 
plentiful  distribution  of  the  Nourishment  to  the  external  and  first 
affected  parts:  and  in  the  mean  time  it  is  rather  a  pleasure  then  a  trouble 
to  the  Child.  Some  that  the  parts  may  the  more  be  stretched,  hang 
Leaden  Shooes  upon  the  Feet,  and  fasten  weights  to  the  Body,  that  the 
parts  may  the  more  easily  be  extended  to  an  equal  length.  But  this 
exercise  is  only  proper  for  those  that  are  strong. 


ROBERT  PEMELL 

[?-i653] 

A   PEDIATRIST  OF  THE   PROTECTORATE 

IN  the  middle  of  the  seventeenth  century  there  flourished  a 
large  number  of  medical  worthies  about  most  of  whom  we  have 
a  fairly  accurate  knowledge.  There  were  countless  others, 
who  left  no  trace  behind,  or,  if  any,  it  has  been  buried  in  the 
dust  of  the  library.  To  fix  the  period  better,  perhaps,  it  may 
be  mentioned  that  it  was  the  age  of  Louis  xiv  in  France,  and  of 
the  Protectorate  in  England,  and  that  in  1653,  Oliver  Cromwell 
was  made  Lord  Protector  of  the  Commonwealth. 

At  this  time  Cranbrook  or  Cranebrooke  was  a  flourishing 
manufacturing  town  chiefly  concerned  in  making  broadcloth.  It 
takes  its  name  from  a  stream  that  runs  into  the  River  Beult  and 
is  about  forty-five  miles  southeast  of  London  in  the  County  of 
Kent.  From  the  fourteenth  to  the  seventeenth  century,  Crane- 
brooke was  a  place  of  some  importance;  since  then  it  has  fallen 
from  its  high  estate  to  a  market  town  of  about  four  thousand 
inhabitants.  In  this  town,  lived  and  practiced  one  Robert  Pemell, 
who,  in  the  year  that  saw  Cromwell  made  Lord  Protector,  pub- 
lished, on  May  29,  a  little  book  entitled  "De  Morbis  Puerorum." 
This  book  was  printed  in  London  by  F.  Legatt,  for  Philemon 
Stephens,  at  the  gilded  Lion  in  Paul's  Churchyard.  Pemell  had, 
previously,  published  four  other  books,  two  on  simples,  one  on 
diseases  of  the  head,  and  one  on  "Help  for  the  Poor,"  but  of  these, 
more  later. 

Concerning  Robert  Pemell,  we  know  nothing  whatever  except 
what  we  gfean  from  his  books.  His  dates  are  not  in  the  "  Index 
Catalogue"  and  Leslie  Stephen  did  not  think  him  worthy  of 
inclusion  in  the  "Dictionary  of  National  Biography,"  or  perhaps 
the  editors  did  not  know  of  his  existence.  His  book  is  not  listed  in 
Meissner's  "Grundlage."  Pemell  did  nothing,  as  far  as  can  be 
ascertained,  but  practice  his  profession  and  write  five  books.  His 
only  claim  to  fame  is  that  he  left  an  excellent  account  of  certain 

2S5 


286  PEDIATRICS  OF  THE  PAST 

phases  of  practice  as  carried  on  in  his  day.  He  deserves  credit,  too, 
for  writing  his  works  in  English,  being  among  the  first  to  break 
the  shackles  of  scholastic  Latin.  Not  that  he  was  lacking  in 
erudition  himself,  but  he  realized  that  the  best  way  to  help  the  laity 
and  the  young  physician  was  to  write  in  the  tongue  they  under- 
stood best  of  all. 

We  know  nothing  of  Pemell,  and  yet  in  1653,  ne  was  getting 
on  in  years,  for  he  says:  "And  because  I  see  my  glasse  run  apace, 
and  I  know  how  short  my  time  is,  therefore,  I  have  made  the  most 
haste  and  taken  the  present  advantage." 

We  know  nothing  of  Pemell,  and  yet  it  may  be  hazarded  that 
he  required  not  more  than  six  or  seven  hours'  sleep,  used  a  large 
pillow  to  keep  his  head  high,  drank  sack  and  hypocras  and  did 
not  like  such  sweet  wines  as  muscadine  or  malmsie. 

His  first  work  was  entitled : 


DE  MORBIS  CAPITIS; 
Or, 

Of  the  Chief  Internal  Diseases  of  the  Head, 

with 

Their  Causes,  Signes,  Prognosticks,  and  Cures, 

for  the  benefit  of  those  that  understand 

not  the  Latine  tongue. 

By  R.  P. 


This  is  a  little  volume  of  141  pages,  published  by  the  same 
Philemon  Stephens,  this  time  "at  the  guilden  Lyon,"  in  1650.  Our 
author  is,  as  he  says  himself,  methodical.  His  pages  bristle  with 
references  of  the  authors  consulted,  very  much  like  those  of  some 
of  us  moderns.  The  margins  bear  captions,  sometimes  in  English, 
but  often  in  Latin.  He  is  a  learned  man,  and  must  needs  let 
others  know.  His  prescriptions  are  also  in  Latin  and  often  abbre- 
viated according  to  the  manner  of  the  time.  He  borrowed  freely 
from  the  aphorisms  of  Hippocrates,  but  he  gave  credit  where 
credit  was  due,  which  is  more  than  can  be  said  of  many  authors, 
both  ancient  and  modern. 

It  was  not  an  unpleasant  custom  of  the  day  to  have  a  poem, 
usually  in  Latin,  at  the  beginning  of  the  book.  This  was  generally 
written  by  some  one  else  in  praise  of  the  volume  or  of  its  author. 


ROBERT  PEMELL  287 

In  "De  Morbis  Capitis"  this  was  done,  the  Latin  being  rendered 
into  English  and  printed  on  the  following  page.  This  poem  is  an 
interesting  example  of  a  phase  of  medical  publishing  that  has 
fallen  into  complete  disuse. 

Concerning 

A  Book,  intreating  of  the  Diseases  of  the  Head,  and  cure  of  them; 
written  by  Robert  Pemell,  of  Crenebrooke,  Physitian. 

The  Head,  the  Heaven  of  man's  Body  is; 

The  Mind's  high  Palace,  wherein  it  doth  raign; 
The  Fountain,  whence  all  motion  takes  its  rise, 

The  Harbour,  where  the  Senses  do  remain. 
As  many  stars  i'th  the  Sky  conjoyned  shine; 

So  rare  endowments  in  the  head  abound; 
Life,  Health,  Strength,  Reason,  Wit,  do  there  combine, 

And  the  best  Organs  of  the  Soul  are  found. 
If  mudless  be  the  Spring,  and  silver-deer; 

As  Silver-cleer,  the  Streams  will  also  flow; 
From  muddy  Fountains,  muddy  streams  appear; 

And  like  the  Fountain,  do  the  Waters  go. 
Man's  health  doth  much  depend  upon  his  head; 

If  that  be  sound,  th'  whole  body  is  at  ease; 
If  that,  with  illness,  be  distempered, 

On  other  parts  some  weakness  soon  doth  seize. 
Who  then,  to  skilful  Pemell  can  repay 

His  due  reward?  whose  care  has  been  so  great, 
For  this  chief  part,  its  evills  to  display. 

And  of  their  signs,  and  Causes,  to  entreat? 
Who  likewise  hath  us  of  choice  Medicines  told, 

For  every  Evill's  cure,  and  due  relief; 
Whatever  larger  Physick  Volumes  hold 

Good  for  thy  .head,  is  here  compriz'd  in  brief. 
Let  this  good  friend  be  thy  Physitian, 

Whose  skilfull  Counsell,  and  Direction, 
Shall  either  keep  thy  head  in  healthfull  case; 

Or  by  his  Art,  away  the  Evill  chase. 

JOHN   ELMESTON, 

School-Master  of  Cranebrook. 


288  PEDIATRICS  OF  THE  PAST 

Pemell  wrote  two  books  on  simples,  the  first  entitled: 

TRACTATUS 

De  Simplicum  Medicamentorum  Facultatibus 

A  TREATISE 

of  the 

Nature  and  Qualities  of  such  Simples  as 

are  most  frequently  used  in 

MEDICINES, 

both  purging  and  others. 

Methodically  handled  for  the  benefit  of  those 

that  understand  not  the  Latine  tongue. 

To  which  is  added: 

Many  Compound  Medicines  for  most  Diseases 

incident  to  Mankinde:  As  also  two  Alpha- 

beticall  Tables,  very  necessary  for 

the  Reader. 

Together  with 

The  Explanation  of  all  words  or  Termes 

of  Art,  whereby  the  vulgar  may  the  better 

understand  it. 

This  was  printed  by  M.  Simmons,  for  Philemon  Stephens,  at 
the  "guilded  Lyon"  in  St.  Paul's  Church-yard,  1652. 

It  is  delightfully  erudite  with  its  long  list  of  authorities  and 
their  dates.  He  starts  out: 

Courteous  Reader,  as  the  knowledge  of  Diseases  is  most  necessary 
and  usefull  for  such  as  take  upon  them  the  Noble  Art  of  Physik,  so  no 
Iesse  profitable  is  the  knowledge  of  simple  medicines  and  their  nature: 
For  it  is  most  true;  Medicus  tantum  bene  curat,  quantum  recte  cognoscat, 
he  onely  cures  well  that  rightly  knows  diseases  and  their  causes,  as  also 
the  vertue  of  simple  Medicines,  he  cures  best. 

In  his  preface,  entitled  "To  the  kinde  Reader,"  he  discusses 
the  choice  of  medicines : 

Wee  ought  to  give  to  Cholerick  persons  those  things  which  purge 
ChoIIer,  to  Flegmatick  bodies  those  things  which  purge  Flegme,  to 
Hydropicall  that  which  purgeth  water,  and  to  melancholly  persons  that 
which  purgeth  black  ChoIIer  or  Melancholly. 

The  purpose  of  the  book  is  nicely  phrased  as  follows : 

What  I  have  done  herein  and  how  methodicall,  I  have  been,  I  leave 
to  others  to  judge,  for  now  it  is  Coram  Judice,  and  surely  not  without 


ROBERT  PEMELL  289 

error,  for  humanus  est  err  are,  'tis  incident  to  the  best  to  erre;  some  have 
lapsed  herein  before  me,  and  others  will  after  me,  however  let  my  good 
will  be  accepted,  which  if  I  finde,  I  shall  be  encouraged  (God  assisting 
me  with  life  and  strength)  to  publish  some  other  Tracts  usefull  for  the 
vulgar  capacity,  as  also  for  young  Pratitioners. 

The  first  book  on  simples  comprises  170  chapters  and  the 
pages  are  not  numbered.  Starting  with  absinthe,  he  gives  a  method- 
ical account  of  various  herbs  and  roots,  together  with  their 
preparations  and  uses.  While  much,  if  not  most  of  it,  is  regarded 
as  absurd  today,  it  is  not  more  so  than  will  be  our  present-day 
works  on  therapeutics  in  four  hundred  years.  Even  less  so,  one 
imagines  indeed,  with  our  plentitude  of  vaccines,  serums  and 
chemicals.  These  old  fellows  sorted  and  tried  out  the  simples, 
and  while  we  have  discarded  most  of  what  they  prized,  it  must  not 
be  forgotten  that  the  foxglove,  belladonna,  hyoscyamus  and 
numerous  other  potent  drugs  were  the  direct  contribution  of  the 
age,  just  as  diphtheria  and  tetanus  antitoxin  are  among  the 
things  of  value  today,  and  who  knows  but  that  even  these  may 
be  forgotten  tomorrow  in  the  face  of  some  more  efficacious  method 
of  treatment  as  yet  undreamed  of.  So  one  should  read  with  a 
sympathetic  humor  these  old  books  and  not  deal  too  harshly  with 
what  seem  vagaries. 

The  make-up  of  Pemell's  book,  with  its  table  of  remedies 
and  its  table  of  diseases  with  the  remedies  advised,  is  most  modern. 
One  is  amused  to  know  that  he  gives  fourteen  remedies  for  mad 
dog  bites,  fifty-two  for  dropsy,  forty-five  for  epilepsy,  and  to 
provoke  courses,  sixty-four,  this  last  doubtless  as  troublesome  in 
those  days  as  at  present.  A  very  popular  present-day  book  on 
therapeutics  does  not  mention  rabies;  gives  twenty-two  drugs  for 
dropsy,  thirty-three  for  epilepsy,  and  only  eighteen  for  amenor- 
rhea. This  drop  in  figures  for  the  last  named  doubtless  shows  the 
superiority  of  modern  surgery  rather  than  of  morals,  for  remember 
Pemell's  day  anticipated  those  of  "good  King  Charlie." 

Pemell  has  one  advantage,  perhaps,  and  that  is,  that  most  of 
his  simples  were  at  least  harmless.  Taken  all  in  all,  his  is  one  of 
the  least  objectionable  of  such  books  and  is  free  from  the  thera- 
peutic horrors  of  the  time. 

The  chief  interest  in  Pemell  is  in  his  contribution  to  pediatrics. 
It  is  valuable,  as  are  all  the  early  books  on  this  subject,  inasmuch 
as  we  glean  something  of  the  manner  of  practice  of  the  earlier 


29o  PEDIATRICS  OF  THE  PAST 

days  and  also  that  they  act  as  a  sort  of  bridge  or,  perhaps  better, 
stepping-stone  on  which  we  pass  from  decade  to  decade,  or  from 
century  to  century.  Like  the  immortal  bard,  Pemell  is  careless  in 
the  spelling  of  his  name  as  well  as  other  words,  one  of  the  manner- 
isms of  the  time.  His  books  were  issued  by  Stephens  at  "the 
guilded  Lion,"  at  "the  guilded  Lyon,"  and  at  "the  gilded  Lyon." 
The  title  page  of  his  pediatric  contribution  is  as  follows : 

DE  MORBIS  PUERORUM, 

or,  A 
TREATISE 

of  ' 

The  Diseases  of  Children; 
With 
Their  Causes,  Signs,  Prognosticks,  and 
Cures,  for  the  benefit  of  such  as  do  not 
understand  the  Latine  Tongue,  and  very  use- 
ful for  all  such  as  are  House-keepers, 
and  have  Children. 
With  the  Contents  of  several  Chapters,  as  also  an 
Alphabetical  Table  of  all  the  Diseases  mentioned  herein. 
By  Robert  Pemell  Practitioner  in  Physick, 
at  Cranebrooke  in  Kent,  May  the  29,  1653. 
LONDON,  * 
Printed  by  F.  Legatt,  for  Philemon  Stephens,  at  the  guilded  Lion 
in  Pauls  Church-yard,  1653. 

It  is  a  small  book  of  fifty-eight  pages,  divided  into  twenty- 
eight  chapters  as  follows: 

THE  CONTENTS  OF  THE  SEVERAL  CHAPTERS 

Of  Ulcers  and  sores  in  children's  heads 
Of  Lice 

Of  the  Scab  and  Itch 
Of  the  falling  Sicknesse  and  Convulsion 
Of  pain  in  the  ears,  with  inflammation 
Of  breeding  and  coming  of  Teeth 

Of  inflammation  of  the  mouth  and  throat,  with  ulcers  and  sores 
thereof 

Of  Feavers 

Of  the  small  Pox  and  Measles 

Of  watching  out  of  measure  and  want  of  rest 


*De    z5\forbis  Tuerorum, 

TREATISE 

OF 

The  Difeafcs  of  Children  j 

WITH 

Their  Caufes,  Signs,  Prognofticks,  and 

Cures,  for  the  benefit  of  fuch  as  do  not 
undcrftand  the  Latine  Tongue,  and  very  ufc-  , 
ful  for  all  fuch  as  are  Houfe- Keepers, 
and  bare  Children, 

With  the  Contents  of  thcfeveral  Chapters,  as  alfo  an 
Alphabetical  Ttble  of  all  the  Difeifei  mentioned  herein. 

By  ROBERT  TEMELL  Praftkioncr  in Pkjfick* 
at  Crtntbrookf  in  Kent.  May  thcap.  16J3. 


LONDON, 

Printed  by  J.  Legatt,  for  Philemon  Sttfbe*t%  at  the  guilded  Lion 
in  Tauls  Church-yard.     1653. 


Title  page  of  Robert  PemelPs  book. 


292  PEDIATRICS  OF  THE  PAST 

Of  fear,  starting  and  terrible  Dreams 
Of  Rheume,  the  cough,  and  shortnesse  of  breath 
Of  Vomiting,  and  weaknesse  of  the  stomach 
Of  the  Hicket 

Of  the  Consumption,  or  Ieannesse,  and  of  the  Rickets 
Of  Gripings  and  fretings  in  the  belly 
Of  looseness  and  flux  of  the  belly 
Of  costiveness  and  stopping  of  the  belly 
Of  Worms 

Of  Ruptures  and  Burstings 
Of  swelling,  or  coming  forth  of  the  Navel 
Of  inflammation  of  the  Navel 
Of  the  swelling  of  the  Cods 
Of  falling  of  the  Fundament 
Of  the  stone,  and  difficulty  of  making  water 
Of  Pissing  in  bed 

Of  the  diseases  called  Saint  Anthonies  fire,  or  wilde  fire,  as  also  of 
burning  and  scalding 

Of  fretting,  chafing,  or  galling  of  the  skin  in  the  groines 

For  ulcers  and  sores  in  children's  heads  he  recommends: 

First,  let  the  child's  head  be  bathed  with  a  decoction  of  Mallows,  and 
Barly,  or  with  a  decoction  of  Dock  roots,  mallows,  Celendine  the  greater, 
Wormwood,  Fenegreek,  Cicers,  Lupines,  Beans,  &c.  If  there  be  need  of 
greater  cleansing,  you  may  boyl  the  foregoing  herbs  in  wine;  or  make  a 
Lotion  with  decoction  of  Marshmallow  roots,  made  with  Urine  of  the 
infant  alone,  or  mixt  with  barley  water.  Then  anoint  the  head  with  oyl 
of  Roses  and  oyl  of  bitter  Almonds  mixed  with  a  little  litharge  of  gold  or 
silver  in  fine  powder;  or  take  of  the  juyce  of  Beets  and  Celendine  the 
greater  of  each  one  ounce,  Hogsgrease  two  ounces;  boyl  them  together 
a  while,  then  being  almost  cold  put  in  of  Brimstone  in  powder  a  drachme, 
make  an  ointment,  with  which  anoint  the  parts  affected  morning  and 
evening.  Or  wash  the  head  with  sope-suds  made  strong.  If  these  ulcers 
eat  to  the  skul,  then  use  hony  of  Roses  mixed  with  a  little  spirit  of  Wine, 
and  afterwards  the  powder  Birthwort  and  natural  Balsam. 

With  the  exception  of  the  use  of  urine,  which  crops  up  in  the 
therapeutics  of  all  ages,  even  in  the  present  enlightened  times,  the 
remedies  are  sound  for  the  most  part.  In  the  first  place,  the  bath 
was  the  thing;  if  that  did  not  cleanse,  he  added  wine,  the  anti- 
septic action  of  dilute  alcohol,  only  he  did  not  have  to  add  phenol 
or  bichlorid  or  other  objectionable  poison,  as  he  lived  in  an  era 
before  the  oligarchy  of  Westerville   had  become   all-powerful. 


ROBERT  PEMELL  293 

Silver  in  fine  powder  finds  its  counterpart  in  the  silver  foil  of 
modern  surgical  dressings.  The  action  of  sulphur  in  suppurating 
skin  diseases  is  well  known  and  is  part  of  the  Hunterian  dictum 
that  there  are  some  skin  diseases  that  mercury  will  cure,  some 
that  sulphur  will  cure,  and  some  the  Devil,  himself,  cannot  cure. 
He  had  curious  ideas  about  the  origin  of  lice,  which  he  declares 
"is  a  foul  and  filthy  disease."  His  therapeutic  suggestions  are 
various,  but  he  closes  with  the  following  paragraph  of  sound 
advice: 

A  powder  good  and  safe  for  lice  in  the  head. 

Take  of  Coculus  Indy  a  quarter  of  an  ounce,  white  Pepper  a  drachme; 
beat  them  into  a  grosse  powder,  and  strew  it  into  the  heads  of  children, 
for  it  will  soon  destroy  the  lice.  Or  you  may  dip  a  comb  in  strong  Mer- 
cury water,  or  water  made  with  Arsenick,  and  so  comb  the  childs  head 
therewith. 

As  might  be  imagined,  he  had  some  suggestions  to  make  on  the 
subject  of  epilepsy,  and  they  are  about  as  satisfactory  as  the 
latest  work  on  the  therapeutics  of  this  disease. 

For  teething,  he  recommends  the  following : 

Let  the  gums  be  often  rubbed  with  the  finger  wet  with  Hony,  or 
with  Hony  and  Butter  mixed  together,  or  with  the  brains  of  a  Hare; 
or  the  brains  of  a  Hare  mixed  with  Capons  grease  and  Hony.  If  you  can 
not  get  Hare's  brains,  take  Conies  brains. 

Rub  the  gums  often  with  red  Coral.  It  is  good  also  to  wash  the  outside 
of  the  cheek  with  a  decoction  of  Mallows  and  Camomil  flowers;  or  to 
anoint  the  same  with  the  juyce  of  Mallows  and  Butter  mixed  together. 

If  there  be  an  inflammation  of  the  gums,  and  the  pain  be  very 
extreme,  use  oyl  of  Roses  with  the  juyce  of  Nightshade. 

If  these  medicines  prevail  not,  as  many  times  comes  to  passe,  then 
the  best  way  is  to  cut  the  gums;  for  this  is  very  safe,  and  were  it  more 
used,  fewer  Children  would  die;  for  I  am  confident  the  want  hereof  doth 
occasion  the  death  of  many  a  child. 

In  his  consideration  of  measles  and  smallpox,  he  employs  the 
usual  absurd  remedies  of  his  day,  but  his  suggestions  have  the 
great  merit  that,  if  they  did  not  help,  they  did  not  hurt.  He  gives 
this  sound  advice  about  the  temperature: 

You  must  not  keep  the  childe  too  hot  nor  too  cold,  for  being  kept  too 
hot  it  may  cause  faintings  and  swoonings,  and  being  kept  too  cold,  it 
may  drive  them  in  again,  and  so  check  and  hinder  nature  from  expelling 
them  out  to  the  skin. 


294  PEDIATRICS  OF  THE  PAST 

One  chapter  in  toto  will  suffice  to  give  one  a  good  idea  of  the 
scope  and  style  of  the  book.  The  one  on  hiccup  is  chosen  partly 
on  account  of  its  brevity : 


chapter  xv — of  the  hicket 
The  Cause 

The  Hicket  in  Children  is  caused  from  the  corrupt  nourishment  in 
the  stomach,  or  from  abundance  of  milk  in  the  stomach,  or  from  the 
coldnesse  of  the  stomach  by  the  outward  air. 

The  Prognosticks 

The  Hicket  in  children  most  times  is  void  of  danger,  and  the  same 
being  taken  away,  it  doth  soon  cease.  But  if  it  happen  to  continue  long, 
or  be  complicated  with  some  other  disease,  as  the  Falling  Sicknesse,  or 
Convulsions,  many  times  it  proves  deadly. 

The  Cure 

If  the  Hicket  come  from  corrupt  nourishment,  or  fulnesse  of  the 
stomach,  'tis  good  to  make  the  child  vomit  either  by  putting  your  finger 
in  the  throat  of  it,  or  by  putting  down  a  feather  anointed  with  oyl, 
or  by  some  other  light  and  easie  means,  that  hereby  the  offensive  matter 
may  be  taken  away;  then  use  means  to  heat  and  strengthen  the  stomach 
as  in  the  13.  Chapter,  and  let  the  child  be  sparing  in  sucking  and  eating. 

If  it  proceed  from  corruption  and  fault  of  the  milk,  then  means  must 
be  used  to  amend  the  same  by  good  dyet  of  the  Nurse  as  before,  and  the 
corrupt  milk  to  be  purged  away  by  syrupe  of  Roses,  or  hony  of  Roses 
solutive,  then  to  use  Conserve  of  red  Roses  with  red  Coral  in  powder,  or 
Bole-atmoniack. 

If  it  come  from  cold,  then  let  the  stomach  be  warmed  both  with 
inward  and  outward  means.  Give  the  child  sirup  of  Mints,  or  sirup  of 
Betony,  and  let  the  stomach  be  bathed  with  a  decoction  made  of  Mints, 
Organy  Wormwood  &  Cyperus  roots;  afterward  anoint  the  stomach  with 
oyl  of  Dil,  oyl  of  Mastick,  or  oyl  of  Mints;  or  apply  a  Pultis  made  with 
Mints  and  Dill  seed  bruised,  and  oyl  of  Mastick.  Or, 

Apply  Mastic  and  Frankincence  in  powder  (mixed  with  the  white  of 
an  egg)  to  the  hole  of  the  stomach. 

Or  take  of  Mastick  one  ounce,  Frankincense,  Dill  seed,  ana  5ii» 
make  them  into  powder,  and  mix  them  with  the  juice  of  Mints,  then  wet 
Hempen  clouts  therein,  and  apply  it  to  the  stomach  warm. 


ROBERT  PEMELL  295 

He  hit,  perhaps  unconsciously,  upon  the  present-day  idea  of 
infantile  diarrhea  when  he  stated  that  "The  cause  hereof  (of 
looseness  and  flux  of  the  belly)  is  bad  concoction,  or  corruption 
of  the  milk  or  nourishment."  He  continues  further  on: 

Sometimes  when  children  do  not  breed  teeth,  the  cause  may  be  from 
the  outward  air,  whereby  the  stomach  &  belly  of  the  child  are  too  much 
cooled,  and  thereby  concoction  is  hindered;  or  when  the  stomach  is 
oppressed  with  too  much  food  our  nourishment  whereby  crudities  and 
corruption  of  the  food  doth  follow,  so  that  if  the  same  be  not  rejected 
or  cast  up  by  vomiting,  it  is  carried  down  to  the  belly  and  causeth  these 
fluxes:  or  it  may  arise  from  bad  nourishment,  or  from  the  badnes  of  the 
milk,  from  whence  corrupt  juyce  is  bred  in  the  stomach  which  nature 
expels  by  stool.  Sometimes  it  may  proceed  from  the  moistnes  and  Ioosenes 
of  the  bowels,  which  moisture  hath  it  original  from  some  sharp  humours 
in  the  stomach,  and  from  thence  falls  down  into  the  bowels. 

The  above  is  very  sound  and  essentially  the  teaching  of  today, 
although  phrased  differently.  Incidentally  he  knew,  as  did  the 
ancients,  that  a  diarrhea  should  not  be  checked  too  suddenly. 

If  the  flux  in  children  be  not  violent,  the  danger  is  not  great,  neither 
must  it  be  suddenly  stopped,  because  the  corrupt  humours  in  the 
stomach  hereby  are  evacuated  or  purged,  which  if  they  were  stopt  would 
prove  dangerous. 

He  follows  this  with  sound  advice: 

If  the  Infant  suck  or  not,  and  the  flux  be  of  some  continuance,  means 
must  be  used  to  stay  it,  and  such  means  as  first  cleanse  and  then  bind 
the  body,  as  sirup  of  Roses  solutive,  or  hony  of  Roses  solutive.  Clysters 
may  be  used. 

The  danger  of  milk  in  certain  forms  of  diarrhea  was  noted, 
perhaps  a  little  vaguely: 

Some  commend  the  maw  of  a  Kid,  or  Hare,  if  ten  grains  thereof  be 
given,  and  the  child  to  take  no  milk  that  day,  least  it  curdle  in  the 
stomach;  but  give  it  bread  boyled  in  water  with  Rosewater  and  Sugar. 

The  chapter  on  worms  is  most  interesting,  but  is  too  long 
to  reproduce  here.  The  first  part  will  suffice: 

Among  all  the  diseases  that  are  incident  to  children,  this  of  Worms 
is  not  the  least.  There  are  three  sorts  of  wormes,  round,  flat,  and  small 
worms  called  Ascharides,  and  are  bred  in  the  fundament. 


296  PEDIATRICS  OF  THE  PAST 

The  Cause 

Worms  are  caused  of  a  crude  and  putrified  flegme  and  other  ill 
humours,  but  never  of  ChoIIer  or  Melancholy.  For  all  bitter  things  kill 
worms.  All  manner  of  fruits  also  breed  worms,  especially  in  children  and 
moist  bodies. 

Signs  of  Long  and  Round  Worms 

The  Signs  of  long  and  round  worms  are  these;  the  mouth  aboundeth 
with  moisture,  the  breath  stinketh :  terrible  and  fearsome  dreams  follow, 
and  they  gnash  and  grind  their  teeth  in  their  sleep,  and  start  suddenly 
in  their  sleep,  their  tongues  are  hot  and  dry,  and  they  often  rub  their 
noses;  they  have  a  dry  cough,  and  sometimes  vomiting  andtheHicket 
followeth:  they  feed  much  sometimes,  and  sometimes  little;  great 
drought  doth  most  times  accompany  wormes,  the  belly  is  hard  and 
swollen,  and  sometimes  bound,  but  most  times  loose.  The  urine  is  most 
times  white  and  thick,  and  great  gripings  of  the  belly  doth  follow,  espe- 
cially when  the  belly  is  empty.  The  body  waxeth  lean  for  want  of  that 
nourishment  which  the  worms  consume.  Ofttimes  they  have  cold  sweats, 
the  face  is  sometimes  red,  and  sometimes  pale,  and  many  times  they 
are  taken  with  Convulsions,  and  fevers  happen.  The  pulse  is  very 
uncertain.  But  the  most  certain  sign  of  all  is,  when  they  void  worms  in 
their  excrements. 

Pemell  indulges  in  sundry  vagaries  regarding  external  appli- 
cations, an  error  not  entirely  confined  to  those  of  earlier  days 
and  the  vulgar.  For  example,  he  recommends: 

Outward  Means  to  Kill  Worms 

Outward  means  are  to  be  used  also;  as  you  may  boyl  Wormwood 
and  Centory,  Peach  leaves  and  Lupins  in  water,  and  apply  them  warm 
to  the  belly,  or  apply  Cumin  seed  with  Ox  gall,  or  Bulls  gall,  or  anoint 
the  belly  with  oyl  of  Savin,  or  oyl  of  Rue,  morning  and  evening  warm. 

Now  and  then  Pemell  forsakes  his  simples  and  wanders  forth 
into  the  realms  of  the  pharmacopeia,  so  popular  in  his  time. 
Fortunately,  he  does  not  do  this  often.  A  specimen  of  a  prescrip- 
tion for  incontinence  of  urine  is  as  follows : 

Take  a  Hogs  bladder,  or  Bores,  or  sheeps  bladder  dryed,  the  stones 
of  a  Hare,  and  the  Wesand  of  a  Cock  dryed,  of  each  half  a  drachme, 
Acorn  cups  two  scruples,  Nep  and  Mace,  of  each  a  scruple;  make  all 
into  powder,  and  give  hereof  a  scruple,  or  half  a  drachme  in  the  distilled 


ROBERT  PEMELL  297 

water  of  Oaken  leaves;  or  give  ten  grains,  or  a  scruple  of  Acorn  cups  in 
powder,  morning  and  evening  in  Plantain,  or  Oaken  Ieafe  water. 

Of  course,  such  suggestions  provoke  a  smile,  and  yet  in  four 
hundred  years  from  now  there  may  be  some  who  will  laugh  at  some 
of  our  present-day  therapeutics.  These  things  are  no  worse  than 
the  desiccated  glands  as  advertised  and  written  about,  witness  the 
modern  articles  on  endocrinology,  the  numerous  serums  and  vac- 
cines, but  few  of  which  will  last  a  hundred,  much  less  four 
hundred,  years. 

Pemell  also  wrote  a  book  called  "Help  for  the  Poor,"  a  popular 
treatise  on  disease,  its  cure  and  prevention,  but  a  copy  of  this 
book  is  not  to  be  found  in  any  of  the  larger  libraries  of  this  country. 
It  places  him  forever  among  the  front  of  the  welfare  workers,  as  it 
dealt  with  affections  most  common  among  the  indigent.  It  con- 
cerned the  diseases  of  children  in  particular,  and  this  also  places 
him  among  the  pioneers  of  the  prevention  of  disease  and  death 
among  the  young.  Unheard  of,  almost  entirely  forgotten,  he  was 
in  his  time  a  power  for  good  and  for  progress.  Just  how  much  he 
influenced  his  contemporaries  and  successors  it  is  difficult  to  judge, 
for,  if  he  had  a  following,  they  did  not  herald  his  name  as  one  who 
led  them.  In  a  fairly  extensive  reading  of  the  earlier  pediatric 
literature,  his  name  has  not  been  met  with;  yet  he  must  have 
wielded  a  considerable  influence. 

Such  is  the  history  and  work  of  Robert  Pemell,  as  far  as  one 
can  give  it  today.  An  author  of  merit,  a  clinician  of  ability,  a 
pediatric  thinker  in  some  ways  ahead  of  his  time,  and  one  of  the 
early  workers  in  the  field  of  infant  welfare;  his  memory  deserves 
to  be  kept  green. 


FRANCIS  SYLVIUS  AS  A  PEDIATRIST 

[1614-1672] 

IT  is  a  curious  fact  that  the  great  men  of  medicine  have  had  but 
scant  attention  paid  to  their  lives.  Enthusiasts  have  remedied 
this  to  a  certain  extent,  but  men  who  have  moulded  medical 
thought  and  who  ought  to  be  familiarly  known  to  us  who  follow 
in  their  footsteps  are  often  only  names  appended  to  some  part  of 
the  body  or  to  some  disease. 

The  student  of  anatomy  meets  Sylvius  early,  for  when  the 
mysteries  of  the  brain  are  mastered,  he  has  encountered  the  name 
five  times:  in  the  fissure  of  Sylvius,  the  aqueduct  of  Sylvius, 
the  ventricle  of  Sylvius,  the  fossa  of  Sylvius  and  the  Sylvian  artery. 
Until  recently  the  various  authorities  ascribed  most  of  these 
things  to  Jacobus  Sylvius,  one  of  the  teachers  of  Vesalius,  but  as 
Baker1  has  pointed  out,  it  was  Francis  Sylvius  who  described  these 
structures,  although  the  aqueduct  had  been  previously  observed 
by  Arantius  in  1587  and  even  by  Galen.  Francois  Dubois,  or  in 
the  more  musical  dialect,  Franciscus  de  Ie  Boe,  as  he  was  known 
until  he  adopted  the  latinized  form  of  Franciscus  Sylvius  after 
he  had  been  graduated  in  medicine,  was  of  old  French  stock; 
but  owing  to  religious  persecution,  his  father  had  settled  in  Hanan 
in  Germany  and  the  young  Francis  was  born  there  in  1614.  He 
was  sent  to  Sedan  to  be  educated  and  after  some  years  of  study 
there,  traveled,  as  was  the  custom  in  those  days.  Paris,  the 
Netherlands  and  Germany  taught  him  chemistry  and  anatomy, 
as  well  as  physics,  botany  and  zoology.  By  the  time  he  was  twenty- 
three,  in  1637,  he  had  reached  Basel,  drawn  doubtless  by  the  fame 
of  the  great,  but  bombastic,  Paracelsus,  who  ten  years  before  had 
publicly  burned  the  books  of  Galen  and  Avicenna.  Here,  Sylvius 
was  admitted  to  the  profession  of  medicine;  shortly  after,  at  the 
request  of  his  father  he  returned  to  Hanan  to  practice  for  two 
years,  when  he  pushed  on  to  Paris  and  thence  to  Leyden,  where  he 
started  his  famous  courses  on  anatomy.  He  became  the  vogue, 
and  students  flocked  to  his  dissecting  rooms  to  listen  to  his 
demonstrations.  From  all  over  Europe  they  came,  among  the  lot 

1  Baker,  F.  The  two  Sylviuses,  Jobns  Hopkins  Hosp.  Bull.,  xx,  329,  Nov.,  1909. 

298 


FRANCIS  SYLVIUS  AS  A  PEDIATRIST  299 

Willis,  who  carried  on  the  study  of  the  brain  aided  by  the  neglected 
Richard  Lower;  de  Graaf  of  the  Graafian  vesicles;  Stensen,  who 
showed  that  the  heart  and  arteries  are  constructed  of  muscle; 
Swammerdam,  who  described  the  red  blood  corpuscles;  and  Van 
Home,  of  thoracic  duct  fame.  Sylvius  demonstrated  Harvey's 
discovery  and,  as  Garrison  says,  did  for  it  what  Pare  did  for 
Vesalius. 

When  he  was  about  twenty-eight,  he  went  to  Amsterdam  and 
later,  in  1658,  he  returned  to  Leyden  to  occupy  the  chair  of  prac- 
tice of  medicine  left  vacant  by  the  death  of  Kyper.  While  in 
Amsterdam  he  had  married  Anna  de  Ligne,  but  she  and  her  two 
infant  sons  soon  died.  His  second  wife  and  daughter  died  in  1669 
of  some  sort  of  petechial  fever,  probably  typhoid.  Sylvius  had 
described  the  disease  and  suffered  from  it,  but  recovered,  only  to 
succumb  to  it  in  1672.  Lucas  Schacht,  his  friend  and  faithful 
biographer,  who  preached  his  funeral  oration,  was  with  him  in  his 
last  illness  and  Sylvius  said  to  him:  "I  know  as  well  as  you  the 
seriousness  of  the  disease  from  which  I  escaped  three  years  ago. 
This  time  I  shall  die."  Baker  gives  the  following  inscription  from 
the  tomb  in  the  Choir  of  St.  Peter's  Church  at  Leyden,  erected 
seven  years  before  it  was  used.  Before  his  fiftieth  year  Sylvius 
himself  had  prepared  the  sepulchre  and  written  the  inscription. 

FRANCISCUS  DELEBOE  SYLVIUS, 

MEDICINAE  PRACTICAE  PROFESSOR. 

TAM  HUMANE  FRAGILITATIS 

QUAM  OBREPENTIS  PLERISQUE  MORTIS  MEMOR, 

DE  COMPARANDO  TRANQUILLO  INSTANTI  CADAVERI 

SEPULCHRO 

AC  DE  CONSTITUENDA  RUENTI  CORPORE  DOMO 

AEQUE  COGITABAT  SERIO. 

LUGDUNI  BATAVORUM, 

MDCXLV 

[Franciscus  de  Ie  Boe  Sylvius, 

Professor  of  the  Practice  of  Medicine. 

Mindful  of  human  infirmity 

and  of  the  often  stealthy  approach  of  death, 

bethought  him  to  prepare  against  that  time 

a  quiet  sepulchre  for  his  remains, 

a  house  for  his  mortal  body, 

at  Leyden. 

1665.] 


3oo  PEDIATRICS  OF  THE  PAST 

Sylvius  was  a  handsome  man;  as  someone  has  phrased  it,  he 
had  the  "eloquence  of  a  fine  person."  He  possessed  an  amiable 
modesty,  great  sociability  and  a  charming  manner.  He  was 
evidently  just  as  pleasing  in  personality  as  old  Jacobus  Sylvius 
was  the  reverse. 

Sylvius,  in  spite  of  his  detractors,  did  much.  He  believed  in 
drugs;  he  was  a  great  user  of  opium,  so  that  Walter  Harris  dubbed 
him  the  "opium  doctor,"  and  of  antimony,  which  gave  rise  to  the 
saying  that  his  teaching  in  this  regard  was  responsible  for  more 
deaths  than  the  Thirty  Years  War.  As  an  anatomist  he  was  supreme 
and  no  student  of  the  time  who  had  not  attended  his  dissections 
felt  he  really  knew  anatomy.  His  is  credited  with  over  three 
hundred  dissections  of  the  human  body  as  well  as  numerous 
autopsies.  Another  great  feature  of  his  teaching  was  bedside 
instruction.  It  is  supposed  that  such  methods  had  been  used  at 
Bologna  and  Padua,  but  there  is  no  doubt  that  Sylvius,  at  the 
little  twelve-bed  infirmary  in  Leyden,  gave  clinical  instruction, 
as  he  states  in  his  "Epistola  Apologetica,"  written  in   1664: 

I  led  them  by  the  very  hand  into  the  practice  of  medicine,  i.  e.  I  took 
them  daily  into  the  public  hospital  for  the  purpose  of  seeing  the  sick  to 
whose  complaints  and  other  notable  symptoms  I  directed  attention, 
asking  immediately  afterwards  what  they  had  observed  in  the  disorders 
of  the  patient;  their  views  as  to  the  causes  and  proper  treatment  and  the 
reasons  for  the  same. 

There  is  a  much  quoted  paragraph  from  Schacht  describing 
his  method  of  teaching: 

When  he  came  with  his  pupils  to  the  patient  and  began  to  teach, 
he  appeared  completely  in  the  dark  as  to  the  causes  or  the  nature  of  the 
affection  the  patient  was  suffering  from,  and  at  first  expressed  no  opinion 
on  the  case;  he  then  began  by  questions  put  to  different  members  of  his 
audience  to  fish  out  (expiscabatur)  everything  and  finally  united  the  facts 
discovered  in  this  manner  into  a  complete  picture  of  the  disease  in  such 
a  way  that  the  students  received  the  impression  that  they  had  themselves 
made  the  diagnosis  and  not  learnt  it  from  him. 

His  was  the  transition  period  from  alchemy  to  chemistry,  the 
so-called  iatrochemistry  founded  by  Van  Helmont;  and  Sylvius, 
as  Garrison  puts  it,  did  much  to  divest  it  "of  its  fantastic  trap- 
pings." He  also  did  much  to  establish  the  identity  of  organic  and 


Francis  Sylvius 
[1614-1672] 


FRANCIS  SYLVIUS  AS  A  PEDIATRIST  301 

inorganic  chemistry.  He  considered  the  saliva,  the  pancreatic 
secretion  and  the  bile  to  be  chemical  substances  which  caused  an 
" effervescence' '  which  not  only  digested  the  food,  but  in  some 
way  aided  the  production  of  animal  spirits  in  the  brain.  His 
ideas  on  the  ductless  glands  were  the  starting  point  of  our 
modern  knowledge  of  the  subject.  He  discriminated  between  tactile 
and  thermal  sense  and  enunciated  a  theory  of  acidosis,  to  which 
he  attributed,  as  do  we  today,  countless  ills.  Naturally,  with  the 
limitations  of  the  time  many  of  his  conceptions  were  incorrect, 
but  he  was  a  great  teacher  and  gave  an  impetus  to  medical  obser- 
vation and  thinking.  In  considering  the  achievements  of  a  worker 
of  another  century  it  is  necessary  to  get  the  viewpoint  of  the  time, 
to  read  aright  the  queer  phraseology,  to  get  the  idea  rather  than 
the  mere  patter  of  words.  Every  few  years  sees  a  change  in  termi- 
nology and  phrasing,  some  of  it  demanded  by  newer  concepts,  by 
discoveries,  but  much  the  product  of  the  mind  that  finds  it  easier 
to  use  a  new  word  to  express  an  old  idea  or  an  inexplicable  fact 
than  to  make  a  new  discovery  or  interpret  a  phenomenon.  We 
have  today  an  inordinately  complicated  mass  of  fact  and  a  more 
complex  mass  of  theory  and  much  is  explained;  but  of  the  fun- 
damentals, of  the  true  underlying  causes,  we  are  as  ignorant  as 
those  of  the  past.  So  let  us  praise  the  wisdom  of  Franciscus 
Sylvius,  teacher,  anatomist,  physiologist  and  clinician. 

And  now  let  us  look  for  a  moment  at  Sylvius  in  a  new  light, 
as  a  pediatrist.  But  for  Walter  Harris,  who  borrowed  much  from 
him,  as  witness  his  views  on  acids  and  alkalis,  and  scolded  him  for 
having  thought  of  such  things  first,  one  finds  singularly  little 
comment  by  other  writers  of  this  phase  of  his  teaching. 

Sylvius  wrote  one  little  pediatric  text  which  was  printed  in 
Amsterdam  in  1674.  It  is  entitled  "Praceos  medicae  liber  quartus. 
De  Morbis  infantum  et  aliis  quibusdam  memoratu  dignis  affecti- 
bus.  Editus  cura  Justi  Schraderi."  It  was  translated  and  published 
in  London  in  1682  with  the  title,  "Praxeos  medicae  liber  quartus. 
Of  children's  diseases :  given  in  a  familiare  style  for  weaker  capa- 
cities with  an  apparatus  or  introduction  explaining  the  author's 
principles:  as  also  a  treatise  on  rickets." 

A  few  extracts  from  Sylvius  will  serve  to  show  his  sense  and 
style.  Here  as  elsewhere  the  quotations  have  been  chosen  with  a 
view  to  pointing  out  what  sound  common  sense  most  of  these  old 
worthies  had,  and  not  to  hold  them  up  to  ridicule,  as  some  authors 


302  PEDIATRICS  OF  THE  PAST 

do  by  picking  out  the  absurdities  or  comical  errors,  most  of  which 
are  a  reflection  on  the  times  rather  than  on  the  man.  In  a  day  when 
purges,  vomits,  bloodletting  and  sweats  were  the  medical  fashion, 
a  word  of  warning  was  indeed  most  needed  and  Sylvius  appreciated 
that  infants  must  be  treated  with  care. 

Some  of  the  following  paragraphs  need  scant  comment,  if 
any.  The  relief  of  colic  by  means  of  injections  and  the  difficulty  of 
curing  the  acid  conditions  are  striking  features.  On  purging  he  says: 

19.  All  Vomiting  is  a  preternatural  Motion  of  the  Stomach;  for  none 
in  health  vomits;  seeing  that  the  Natural  Motion  of  the  Stomach  begins 
at  its  upper  Orifice,  which  by  a  kindly  contraction  of  itself  thrusts 
whatsoever  is  in  it  through  the  Pylorus,  (that  is,  its  lower  orifice)  to 
the  Guts. 

20.  For  volatile  spirituous  things  need  no  preparation  in  the  Stom- 
ach; which  if  they  do  not  meet  with  any  thing  in  the  Stomach  to  stop 
them,  are  straight  carried  down  to  the  Guts,  and  from  thence  to  the 
Heart;  whereby  the  sick  are  so  speedily  refreshed,  though  never  so  weak 
before. 

26.  It  is  therefore  good,  to  boil  Anise,  or  sweet  Fennel  seeds  in  the 
childs  milk;  or  to  put  grated  Nutmeg  into  their  drink  boil'd  with  bread: 
whereby  the  rise  of  Phlegm  will  be  prevented. 

27.  If  the  Childs  belly  be  much  swelled  with  wind,  and  costive,  it  is 
best  to  give  a  Clyster  before  the  Purge;  which  Clyster  must  be  made  of 
emollients  and  such  as  expel  wind,  with  some  gentle  purger  in*  it;  whereby 
their  hard  excrements  will  not  only  he  softened,  but  the  Wind  it  meets  with 
he  expelled,  or  rather  as  it  were  cboaked,  and  settle  into  the  Clyster,  and  anon 
be  sent  forth,  as  also  a  fit  way  prepared  for  the  humours  and  wind  that  will 
follow  from  the  upper  Guts. 

28.  By  this  method  in  a  little  time  the  Wind  may  be  cured,  which 
cannot  be  on  a  sudden. 

29.  But  if  sowre  Humours  be  joyned  to  the  foresaid  Wind,  or  be 
observed  alone,  the  Cure  will  be  more  difficult. 

24.  For  it  may  happen  to  Infants  as  to  people  of  years,  that  all  are 
not  alike  easily,  speedily  or  largely  purged  by  any  Medicine:  for  which 
cause,  lest  they  should  get  harm  by  a  strong  Medicine,  it  is  better  to  give 
a  gentle  Purge  at  several  times,  and  but  a  little  at  a  time,  rather  than 
together  and  at  once.  For  a  Physician  cannot  be  too  cautious,  seeing 
children  are  tender,  and  may  die  upon  a  small  occasion. 

*As  for  example,  Take  Marshmallow  roots  two  drachms,  Mallow  and  Rue 
leaves,  of  each  an  handful,  which  boil  in  barley-water,  strain  four  ounces,  in 
which  dissolve  half  an  ounce  of  the  Catholick  Electuary,  Oil  of  Roses  two 
drachms,  and  give  it  blood  warm. 


FRANCIS  SYLVIUS  AS  A  PEDIATRIST  303 

Elsewhere  the  constant  occurrence  of  hiccup  is  referred  to. 
Sylvius  vaunts  an  aromatic  in  vogue  to  this  day  and  he  does  it 
in  two  lines. 

35.  Among  other  things  I  have  observed  that  Mint  and  its  Water  is 
very  good  against  the  Hicket. 

On  convulsions  he  writes  learnedly,  but  does  not  get  very  far, 
and  indeed,  in  this  he  differs  not  at  all  from  other  authors  of  any 
age.  We  know  pitifully  little  about  spasmodic  affections,  though 
we  are  somewhat  ahead  of  Sylvius;  witness  the  following: 

THE  FALLING-SICKNESS  DESCRIBED 

i.  We  now  come  to  the  Falling-Sickness,  by  which  many  Infants  are 
taken  away  hence,  and  therefore  the  more  worthy  our  enquiry. 

2.  The  Falling-Sickness  uses  to  follow  Gripes  in  the  Bowels,  and  a 
green  and  sowre-smeWd  purging.  Whence  it  is  judged  to  be  the  chief 
Cause  of  all. 

3.  Now  the  Falling-Sickness  is  a  reciprocal,  and  (for  some  time) 
continued  shaking  of  the  Parts  moved  by  the  Muscles,  as  the  Hands,  Feet, 
Lips,  Tongue,  Eye-lids,  Eyes;  in  one  word  it  is  a  shaking  of  all  the  parts 
which  a  stander-by  can  touch. 

4.  For  it  returns  by  fits,  which  while  it  continues,  Children  can  scarce 
take  any  thing:  I  therefore,  the  more  admired  my  own  daughter,  who 
being  but  eight  months  old,  the  last  day  she  lived  took  the  Falling- 
Sickness,  her  teeth  coming  hardly  forth,  she  took  any  thing  that  was 
given  her  in  the  fit,  which  continued  some  hours,  (and  the  like  I  do  not 
remember  in  either  young  or  old)  but  when  the  fit  left  her,  she  took 
nothing  for  several  hours,  and  at  last  died  quietly. 

6.  As  people  of  years  seem  to  want  all  outward  sense  in  the  Fit,  so  we 
may  judge  the  same  in  Infants. 

7.  I  said,  that  in  the  Fit  they  seemed  to  have  no  outward  sense,  although 
they  commonly  stir  at  any  strong  smell  applied  to  the  Nostrils,  and  some- 
times at  a  loud  noise,  and  especially  at  their  own  name,  spoken  in  at 
their  ear. 

8.  They  are  also  observed  often  in  the  fit  to  be  burnt  to  the  very  bone, 
and  yet  not  awaken:  which  signifies,  that  they  have  no  outward  sense. 

9.  I  know  no  other  reason  of  this  difference,  than  that  the  Cause  of 
the  disease  may  be  changed  by  a  sharp  volatile  Salt;  unless  perhaps  one  out- 
ward sense  may  then  be  more  affected  than  another;  for  which  if  it  be,  I 
could  never  apprehend  a  reason. 

10.  The  most  that  have  these  fits,  when  they  come  to  themselves,  know 
not  what  they  suffered,  and  scarce  complain  of  any  other  thing,  than  an 


304  PEDIATRICS  OF  THE  PAST 

heavy  head  ach;  unless  perhaps  during  the  Fit  some  part  be  bruised  by 
vehement  motion,which  is  felt  after  the  fit. 

ii.  For  this  is  to  be  noted,  that  the  most  are  more  stupid  after  the  fit; 
and  if  the  fits  often  return  violent,  they  continue  after  them  stupid,  and 
sometimes  foolish. 

12.  All  which  are  evident  signs  that  the  Falling-Sickness  affects  the 
whole  Brain;  so  that  many  say,  if  all  the  Brain  be  not  chiefly  affected  in 
the  Falling-Sickness,  then  is  the  Root  of  the  Marrow  of  the  Back,  and  the 
Beginning  of  the  Nerves. 

13.  For  the  outward  Senses  and  Animal  Motion  are  manifestly  affected; 
and  so  are  the  Inward  Senses,  when  they  become  stupid;  also  the  Head 
must  of  necessity  be  affected,  because  of  its  heavy  pain  after  the  fit. 

14.  Seeing  therefore  that  the  most,  if  not  all  the  functions  of  Life  are 
affected  in  and  by  the  Falling-Sickness,  we  must  enquire  what  it  is,  and 
what  parts  are  ill  affected? 

He  pays  his  tribute  to  thrush,  from  which  account  a  few 
paragraphs  may  be  cited: 

1.  The  Tbrusb  is  a  common  distemper  among  Infants,  being  small 
Ulcers  spread  all  over  the  Mouth,  sparing  no  part  of  it,  neither  the  Tongue, 
Palat,  Gums,  Lips,  Balls  of  the  Cheeks,  Jaws,  not  the  Mouth  of  the 
Stomach,  no  nor  the  Stomach  itself,  as  far  as  may  be  conjectured. 

2.  The  small  Ulcers  when  they  appear  first,  are  few,  and  thin  upon  the 
Tongue,  and  Jaws  next  the  Palat;  afterward  they  multiply,  and  grow 
into  one. 

3.  The  thrush  differs  from  all  other  Ulcers,  in  that  it  is  covered  with  a 
Scab,  whereas  others  have  only  filthy  matter. 

His  chapter  on  teething  contains  considerable  old  information 
on  the  subject.  His  therapy  is  in  part  modern,  but  hare's  brain 
comes  in  again  and  the  blood  of  a  cock's  comb  is  also  recommended. 
Just  where  he  got  the  idea  of  the  teeth  of  fierce  wild  beasts  sending 
forth  a  volatile  salt  fume  would  indeed  be  interesting  to  know. 

OF  CHILDRENS  GETTING  TEETH 

i.  The  difficult  getting  of  Teeth  deserves  not  the  last  place  among 
those  Diseases  that  frequently  and  grievously  afflict  Infants,  seeing  that 
they  often  endure  an  exceeding  pain  in  the  Gums,  and  a  troublesome  beat 
in  the  mouth,  and  also  an  inflammation  of  the  Gums,  yea  the  Falling-Sick- 
ness, and  sometimes  death  thereby. 

2.  Teeth  commonly  appear  in  Infants  after  the  sixth  month,  in  some 
sooner,  that  is,  in  the  third  or  fourth  month,  in  many  later,  after  they  are 
eight  or  nine  months  old,  yea,  sometimes  only  after  a  year. 


FRANCIS  SYLVIUS  AS  A  PEDIATRIST  305 

3.  Some  get  them  without  much  trouble;  many  with  trouble,  especially 
if  many  teetb  come  together ,  or  the  Eye-teeth. 

4.  Commonly  the  fore  teeth  come  first,  both  upper  and  under,  whether 
they  come  together,  or  apart;  then  the  outer  teetb;  eight  in  all. 


THE  CAUSE 

5.  The  Cause  of  difficult  toothing,  is  sometimes  in  the  Teeth,  when  they 
grow  slowly,  and  are  blunt,  and  so  cut  the  Gums  more  difficultly. 

6.  Sometimes  in  the  Gums,  when  their  substance  is  more  solid  and  hard, 
not  being  easily  cut  by  the  Teeth. 

7.  Which  difficult  cutting  coming  slowly,  causeth  pain  in  them,  being 
sensible  parts,  and  because  the  substance  of  the  Gums  is  worn,  and  as  it 
were  bruised,  Blood  runs  out  of  their  vessels,  and  is  stopped  in  their 
substance,  whence  comes  an  Inflammation  there,  with  great  pain  and 
beat,  accompanied  with  waking,  whence  arises  a  continual  Fever,  different 
according  to  the  various  depravation  of  Humours  in  the  body,  often 
raising  sowre  vapours,  which  coming  to  the  beginning  of  the  Nerves,  and 
provoking  them  bring  the  Falling-Sickness. 

8.  To  prevent  all  these  evils,  and  if  they  be  present,  The  Cure.  To 
cure  them;  we  must  endeavor,  if  the  teeth  come  slowly,  or  the  Gums  be 
hot  and  pained,  to  soften  and  mitigate  them,  and  so  promote  their  cutting 
the  Gums. 

9.  To  soften  the  Gums  we  commend  unsalted  Butter,  alone  or  with 
Honey;  if  with  ones  finger  they  be  often  smeared  therewith;  as  also  with 
Cream. 

10.  To  this  end  we  commend  Hares  Brains  used  the  same  way. 

11.  Yea  some  commend  the  blood  that  drops  from  a  Cocks  Comb  cut  off, 
and  rubbed  likewise  on  the  Gum. 

12.  It  is  usual  to  make  an  Instrument  of  Ivory,  Crystal,  Silver,*  or 
any  other  solid  and  hard  thing,  and  put  it  between  the  Gums,  whereby 
the  Teeth  cut  through  them  the  easier,  being  pressed  by  Infants  biting. 

13.  To  this  end  many  commend  Wolfs  Teeth,  as  better  than  other 
hard  things;  which  if  so,  we  may  ascribe  it  to  the  volatile  Salt  in  them. 

14.  And  indeed  the  Teetb  of  some  fierce  wild  Beasts,  as  they  are  very 
hard,  so  tbey  send  forth  a  volatile  salt  fume,  very  piercing,  upon  which 
accounts  they  help  to  cut  the  Gums. 

15.  As  those  Teeth,  and  other  things  now  mentioned,  may  be  held 
in  the  mouth,  to  be  bitten;  so  should  they  be  moved  all  along  the  Gums, 
which  is  pleasant  to  Infants,  and  helps  to  let  out  the  Teeth. 

16.  The  foregoing  Treatise  will  afford  the  Cure  of  what  sickness 
usually  attends  Infants  toothing. 

*  Also  of  Coral. 


H- 


Dr.  Franc  feus  de  k  RfifSylVittiTpKi 

Childrens   Difgafes-: 

Given  in  a  familiar  ftyle  for  weaker  capacfBcs. 
WITH    AN 

APPARATUS 

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Introdu&Jon  explaining  the  Au- 
thors Principles :  As  alfb  n 

TREATISE 

O  T    T  H  £ 

R  I CKETS. 

By  %  C.   Phyfici.in. 


Hp. 
Refte  curaturum,  qnem  prima  origo  Cauf* 
non  fefcllcrit.    Cellos  dc  Med. 

Lovdony? anted  for  George  Downs  at  the  Three 
Flower  de  Luces   in  fleet  ft reet ,    over  . 
againftSr.D^^s Church.  i68z. 


English  edition  of  Franciscus  Sylvius'  book  on  the  disease  of  children. 


FRANCIS  SYLVIUS  AS  A  PEDIATRIST  307 

In  his  chapter  on  scurf  and  scab,  he  mixes  up  scabies  and 
seborrheic  eczema,  or  eczema  pure  and  simple.  Both  diseases,  he 
figures,  are  due  to  the  same  cause,  an  acid. 

OF  THE  SCURF  AND  SCAB 

i .  We  come  now  to  the  Worm  and  Scab,  often  troublesome  diseases  to 
Infants. 

2.  The  Scab  goes  over  all  parts  of  the  body,  most  commonly  the  Face 
and  Breast,  seldom  the  arms  or  other  parts,  as  though  the  Skin  were 
eaten  with  small  Worms,  from  which  a  tough  Humour  like  Dew  comes 
forth,  making  scabs  of  sundry  colours. 

3.  The  Scurf  troubles  the  Head,  especially  where  Hair  grows,  so  that 
the  hair  oft  falls  off,  and  slowly  or  never  grows  again,  leaving  watry  prints 
in  the  Head  without  hair. 

4.  Seeing  the  Causes  and  Cure  of  these  two  differ  not  much,  we 
intend  to  discourse  of  them  together. 

5.  In  this  Scab  little  blisters  are  wont  first  to  break  out,  in  any  part  of 
the  Skin,  but  especially  the  face,  ears,  or  arms,  sometimes  almost  over  the 
whole  body;  with  a  great  itching;  by  reason  of  which  Infants,  if  they  can, 
do  scratch  the  parts  affected,  and  if  they  cannot,  they  rub  their  face  at 
any  thing  they  meet  with,  nor  do  they  leave  off,  although  after  rubbing 
the  parts  be  red,  and  the  outer  skin  opened,  and  both  a  sharp  and  biting 
Liquor,  and  also  Blood  runs  out:  by  all  which  the  evil  is  not  lessened  but 
rather  encreased,  by  spreading  more,  and  breeding  new  trouble  elsewhere. 

6.  The  humour  proceeding  by  that  rubbing  is  either  watery,  or 
yellow,  or  of  a  darker  colour. 

THE  CAUSE 

7.  The  same  humour  is  sharp,  and  is  tasted,  found  Sowre,  and  inclin- 
ing to  a  brinish  Saltness. 

8.  The  same  humour  is  tough  and  clammy,  sticking  to  the  parts,  and 
growing  in  a  lump,  and  breeding  a  Scab,  which,  if  the  part  be  not  bare,  as 
is  the  face,  it  cleaves  to  their  shirts,  so  as  not  to  be  removed,  unless  the 
cloaths  be  warily  moistened  before,  thereby  the  Scab  may  be  left  on  the 
part,  which  must  be  done,  if  the  Scab  be  soon  cured. 

9.  Beside  the  Itching  a  great  beat  is  felt  in  the  part  affected,  manifest  to 
feeling:  which  I  judge  is  stirred  up  by  a  bad  effervescency  there,  which  is 
hot. 

10.  And  he  who  knows,  that  there  are  only  two  sorts  of  sharp  Salts  of 
contrary  natures,  sl  Lee  and  sowre  Salt;  and  as  they  meet,  more  or  less  pure 
do  make  an  effervescency  or  opposition,  often  accompanied  with  beat, 
seldom  with  cold;  may  easily  conjecture,  that  one  or  both  of  these  Salts 


3o8  PEDIATRICS  OF  THE  PAST 

are  amiss  in  the  Infants  body  in  this  disease:  which  being  driven  by  the 
blood  to  the  outside  of  the  Body,  stops  there,  and  breeds  this  troublesome 
distemper. 

1 1 .  From  the  aforesaid  Symptoms  of  this  Scab  we  may  conclude,  that 
it  is  caused  by  a  sharp  and  also  tough  humour;  but  sowre. 

12.  And  why  sowre?  Because  any  sowre  thing  soon  joyns  itself  to  a 
tough  and  phlegmatick  humour,  and  is  carried  with  it  all  about  the  body; 
to  which  if  a  Lee  Salt  be  joined,  it  readily  turns  into  wind,  or  at  least  doth 
more  blunt  that  Salt. 

13.  Upon  this  principle  confirmed  by  my  practical  and  chymical 
observations,  I  thought,  that  Lee  Salts,  mild  and  fixed,  such  as  is  in 
unslaked  Lime,  or  any  kind  of  volatile  Salts  were  helpful  both  by  reason 
of  its  sowre  sharpness,  and  tough  Phlegm;  nor  did  my  hope  deceive  me, 
for  /  have  cured  many  by  both  these  Salts. 

14.  These  sowre  and  sharp  humours  stick  in  the  outside  of  the  body, 
sometimes  because  of  the  toughness  of  Phlegm  mixed  with  them,  sometimes 
by  some  fault  in  diet;  as  cold  during  Sweat,  which  stopping  the  pores 
hinders  the  outlet  of  those  humours;  and  so  makes  an  imperfect  Crisis, 
as  being  separated  from  the  blood,  but  stopt  in  the  pores  of  the  Skin, 
which  may  be  got  also  by  cold  shirts. 

15.  These  humours  sticking  in  the  outside  of  the  body  grow  worse, 
and  corrupt  the  Blood  that  comes  near,  and  cause  an  itching  and  pain 
in  the  parts  near  them,  which  being  opened  by  violent  rubbing  the  bad 
humour  comes  out,  and  gets  sharpness  by  the  air,  like  a  load-stone 
attracting  parts  like  it  self  in  the  air  unto  it. 


W: 


RICHARD  WISEMAN 
[1622- 1 676] 

'HEN  one  hears  of  the  "King's  Evil"  a  mental  picture 
comes  up  of  a  gracious  sovereign  touching  the  children  of 
the  poor  to  cure  it.  The  "King's  Evil,"  a  captain  of  the 
men  of  death,  the  hated  destroyer  of  both  rich  and  poor,  a  scourge 
of  God  as  a  punishment  for  man's  ignorance  and  carelessness,  it 
could  not  be  cured  and  eradicated  by  the  royal  favor  of  the  laying 
on  of  hands.  There  were  those  who  struggled  to  understand  it,  to 
abate  it,  to  rob  it  of  its  terrors,  and  of  these  the  Sergeant-Surgeon 
Wiseman  was  not  one  of  the  least.  He  has  left  us  a  little  essay  on 
the  subject,  which  gives  a  very  good  idea  of  the  state  of  mind 
regarding  tuberculosis  in  children  in  the  time  of  the  Common- 
wealth and  of  the  Civil  Wars. 

Wiseman  was  doubtless  a  Londoner  and  as  far  as  it  can  be 
placed  with  reasonable  accuracy,  his  birth  occurred  about  1621 
or  1623.  Sidney  Young  found  a  record  of  his  apprenticeship  in 
the  records  of  the  Barber-Surgeon's  Company,  about  the  year  1637: 

"Of  Richard  Smith,  Surgian,  for  Richard  Wiseman,  ij.s.  vj  d." 

There  has  been  considerable  misinformation  printed  about 
Wiseman,  but  as  much  of  this  as  is  possible  has  been  corrected  by 
Sir  Thomas  Longmore.  Various  estimates  have  been  made;  he 
has  been  rated  anywhere  from  "The  Pare  of  the  English,"  to  a 
mere  copyist  of  Magati,  an  Italian  of  whom  Wiseman  doubtless 
never  heard,  much  less  read.  Haeser  counts  him  not  as  a  surgeon 
of  the  first  rank,  but  as  one  standing  out  prominently  amongst 
those  of  his  time. 

He  began  his  career  as  a  naval  surgeon  under  the  Dutch  flag, 
then  became  an  army  surgeon  and  later  in  life  again  saw  sea 
service  in  the  navy  of  Spain.  This  was  no  unusual  thing  in  those 
days;  an  English  surgeon  might  serve  under  the  flag  of  a  nation 
which  was  at  the  time  friendly  with  England,  much  as  we  once 
admitted  Japanese  as  cadet  midshipmen  at  the  Naval  Academy, 
and  officers  changed  easily  from  naval  duty  to  a  post  in  the  army. 

309 


3io  PEDIATRICS  OF  THE  PAST 

There  is  no  record  of  the  dates  of  Wiseman's  service  in  the 
army,  but  he  was  in  action  under  Charles  i  in  Dorsetshire,  Somer- 
setshire, Devonshire,  Cornwall,  at  the  siege  of  Weymouth,  where 
he  narrowly  escaped  capture  by  the  Roundheads.  Under  the 
Prince  of  Wales,  nominally  the  head  of  the  army,  he  partici- 
pated in  various  activities  and  later,  when  the  Prince  had  become 
King  he  was  with  him  in  Scotland  in  1650  and  1651,  until  the 
defeat  of  the  King's  army  at  Worcester.  It  has  been  surmised 
that  Wiseman's  relations  to  the  Prince  of  Wales  were  more  than 
professional.  It  is  certain  that  he  was  with  him  in  the  Hague  at  the 
time  of  the  death  of  Charles  1,  and  later  he  was  on  board  the  boat 
that  conveyed  Charles  11  to  Scotland  in  1650.  As  Longmore  states, 
Wiseman's  career  as  an  army  surgeon  ended  with  the  defeat  of 
the  King's  forces  at  Worcester.  He  was  captured  and  detained  at 
Chester,  during  which  time  he  was  called  on,  from  time  to  time, 
to  operate  on  injured  persons.  Finally,  when  allowed  to  leave, 
he  gradually  worked  his  way  to  London,  arriving  early  in  1652. 
Obtaining  his  freedom  from  the  Company  of  Barber-Surgeons, 
he  secured  the  rights  and  privileges  of  the  City  of  London.  Thus 
it  was  some  fifteen  years  after  his  apprenticeship  that  he  took  up 
his  freedom,  but  this  was  doubtless  due  to  the  fact  that  until 
he  intended  to  settle  in  London,  this  was  not  essential.  He  became 
an  assistant  to  "a  most  excellent  chirurgion,"  as  he  calls  him,  a 
man  by  the  name  of  Molins.  At  this  time,  Wiseman  was  under 
bail  to  appear  at  court  as  required,  as  on  his  return  to  London  he  had 
been  arrested  with  the  others  of  the  Royalist  Army.  Indeed,  in 
1654,  he  was  arrested  and  imprisoned.  He  had  given  up  his 
position  with  Edward  Molins  and  had  established  himself  in  the 
Old  Bayley  at  the  Sign  of  the  King's-head. 

Wiseman's  arrest  was  due  to  his  having  rendered  professional 
services  to  a  Royalist  prisoner  in  the  Tower.  One  of  the  guards 
confided  to  Wiseman  that  he  was  going  to  effect  the  escape  of  this 
person  and  pretended  to  ask  his  advice.  This  was  a  trap  into  which 
Wiseman  unwittingly  fell,  although  he  protested  his  innocence. 
Between  midnight  and  one  o'clock  of  the  morning  Wiseman  was 
hauled  out  of  bed  by  the  authorities,  his  house  was  searched,  and 
the  result  was  a  short  stay  in  the  Tower  and  some  months  in 
Lambeth  House,  which  was  then  used  as  a  prison.  Set  at  liberty, 
it  appears  that  after  a  couple  of  years  spent  in  London  he  served 
in  the  Spanish  Navy  until  about  1660,  when  he  returned  to  the 


■Shr/it/lt/   /If.,,,,,,,,,       /'  '/./(, 


0( 


Richard  Wiseman 
[1622- 1 6~6] 


RICHARD  WISEMAN  3 1 1 

house  in  Old  Bailey,  where  he  was  practicing  when  Charles 
11  and  his  court  returned.  Some  time  later,  he  removed  to  Covent 
Garden  where  he  practiced  until  his  death. 

Ten  days  after  the  return  of  King  Charles,  Wiseman  was 
appointed  "Surgeon  in  Ordinary  for  the  Person";  Charles  evi- 
dently going  out  of  his  way  to  make  a  post  for  him.  The  following 
year  brought  him  the  royal  warrant  of  King's  Surgeon,  and  in  1672 
he  was  made,  in  the  wording  of  the  royal  warrant,  "Our  principall 
Chirurgion  and  our  Sergeant-Chirurgion." 

His  health  had  not  been  good  after  his  experience  in  the 
Spanish  Navy  and  on  more  than  one  occasion  he  had  hemorrhages 
from  the  lung.  He  evidently  died  of  some  pulmonary  disease. 
The  register  of  St.  Paul's  in  Covent  Garden  contains  the  entry, 
"29th  Aug.  1676,  Richard  Wiseman,  in  the  upper  end  of  the 
church." 

A  well-educated  man  according  to  the  standards  of  the  day, 
Wiseman  wrote  a  fluent  English  with  less  deviation  in  spelling 
than  most  of  his  contemporaries.  He  was  a  water-drinker,  a  total 
abstainer,  but  he  recognized  the  value  of  alcohol  in  keeping  up 
the  vitality  of  those  inured  to  it  through  long  years  of  excess, 
and  he  records  some  interesting  experiences,  and  draws  some  sane 
conclusions.  Some  idea  of  the  character  of  the  man  can  be  gleaned 
by  reading  the  following  extract  from  the  "Letter  to  the 
Reader, "  which  prefaces  the  1676  edition  of  his  book: 

After  all  things  are  considered  and  weighed,  in  this  and  other  Chiru- 
gicall  Discourses  that  are  publick,  and  they  compared  without  success 
in  Practice,  we  shall  soon  find  cause  of  lamenting  our  own  weakness  and 
inability  in  the  carrying  on  of  so  great  a  work  as  the  recovery  of  Man- 
kind out  of  those  many  Distempers  to  which  various  Misfortunes,  and 
many  repeated  successions  of  Intemperance,  and  other  Accidents  both 
without  and  within,  have  betrayed  us  for  so  many  ages  together  .  .  . 
For  my  part,  I  have  thought  it  no  disgrace  to  let  the  world  see  where 
I  failed  of  success,  that  those  that  come  after  me  may  learn  what  to 
avoid:  there  being  more  of  instructiveness  often  in  an  unfortunate  case 
than  in  a  fortunate  one;  and  more  ingenuity  in  confessing  such  mis- 
fortunes which  are  incident  to  mankind,  and  which  have  attended  all 
my  Brethren  as  well  as  myself,  and  will  attend  thee  also,  Reader,  if  thou 
undertake  the  employment.  Thou  wilt  also  learn  one  necessary  piece  of 
Humility,  viz.,  not  to  trust  too  much  in  thy  own  judgment,  especially 
in  difficult  cases,  but  to  think  fit  to  seek  the  advice  of  other  Physicians 


312 


PEDIATRICS  OF  THE  PAST 


or  Chirurgeons,  whose  long  experience  hath  enabled  them  to  assist  thee 
in  preventing  the  Accidents,  and  encourage  thee  to  go  on  in  the  work, 
or  forewarn  thee  of  the  danger.  After  thou  hast  thus  defended  thyself 
from  the  censure  of  Rashness,  proceed  boldyly,  and  let  thy  sincerity 
in  thy  acting  be  thy  warrant  to  hope  for  God's  Blessing  on  thy  endeav- 
ours; and  if  these  Papers  prove  any  advantage  to  thee  in  them,  remember 
with  kindness  the  Labours  of 

Thy  Friend  and  Servant, 
Richard  Wiseman 

A  military  and  naval  surgeon,  Wiseman's  writings  were 
naturally  on  surgical  subjects.  He  is  direct,  forceful,  helpful  and 
the  large  number  of  editions  shows  that  his  opinions  were  valued 
by  the  other  surgeons  of  his  time.  He  was  frank,  honest  and 
without  the  self-praise  found  in  so  many  of  the  early  writers  and 
by  no  means  confined  to  them. 

Wiseman's  works  went  through  seven  editions,  two  appearing 
during  his  lifetime.  The  first  edition  has  for  its  title  page  "A 
Treatise  of  Wounds,  by  Richard  Wiseman,  one  of  His  Majesty's 
Sergeant  Chirurgeons.  London.  Printed  by  R.  Norton,  for  Richard 
Royston,  Bookseller  to  His  most  Sacred  Majesty,  1672."  It  is  an 
octavo  of  277  closely  printed  pages  with  an  appendix  in  which 
it  is  stated  that  the  author  has  several  other  treatises  "which 
roughly  cast"  and  which  will  be  published  if  his  first  venture 
proves  a  success.  Among  these  was  the  paper  on  the  "King's 
Evil."  In  1676  a  folio  edition  of  his  treatise  was  issued.  In  those 
days,  the  publishing  of  books  was  surrounded  by  many  difficulties. 
For  a  certain  period,  1662  to  1679,  books  had  to  be  licensed,  the 
troublous  times  passed  through  were  responsible  for  this  act  of 
Charles  11.  Then  the  corporation  of  the  Barber  Surgeons  had  to 
pass  on  books  on  surgery  written  by  its  associates,  and  in  1558 
there  is  the  entry: 

Ordered:  Yf  any  man  of  this  mysterie  shall  at  any  time  hereafter 
make  any  Booke  or  Bookes  of  Surgerie,  the  same  shall  not  be  published 
unles  the  same  booke  or  bookes  be  first  presented  unto  the  masters, 
governors  and  examenors  of  this  Companie  for  the  tyme  being  on  payne 
of  xu. 


Wiseman's  book  not  only  got  by  the  licensing  bishop  and  the 
Barber  Surgeons,  but  what  was  of  far  more  import  as  far  as  its 


RICHARD  WISEMAN  313 

true  worth  was  concerned,  it  had  the  approval  of  the  Royal 
College  of  Physicians. 

There  is  no  record  of  Wiseman's  having  been  made  a  Master  of 
the  Barber  Surgeons,  but  there  is,  that  he  was  admitted  to  the 
Court  of  Assistants,  probably  with  the  intention  of  qualifying 
as  a  Master. 

The  King's-Evil  is  a  Tumour  arising  from  a  peculiar  Acidity  of  the 
Serum  of  the  Blood,  which  whenever  it  lights  upon  a  Gland,  Muscle,  or 
Membrane,  coagulates  and  hardens;  when  it  mixes  with  Marrow  always 
dissolves  it,  and  renders  the  Bone  carious. 

If  this  acrid  Humour  be  simple,  the  Disease  in  that  Case  is  a  simple 
Struma;  but  if  joined  with  a  Malignity,  or  any  other  Humour,  it  pro- 
duces a  compound  Tumour,  as  Struma,  Maligna,  Phlegmonodes,  Scir- 
rhodes,  Oedematodes,  &c. 

The  immediate  Causes  of  this  Acidity,  or  the  remote  ones  of  the 
Struma,  are  not  easily  enumerated,  but  may  chiefly  be  referred  to  the 
following  Heads,  viz.  Air,  Diet,  Exercise,  natural  Complexion,  hereditary 
Affections,  &c. 

Children  that  are  born  of  strumous  Parents,  or  who  have  sucked 
strumous  Nurses,  are  usually  troubled  with  this  Disease. 

They  whose  Blood  inclines  to  Acidity,  and  the  Serum  apt  to  coagu- 
late, as  also  Children  that  are  Rickety,  are  very  obnoxious  to  it. 

So  likewise  are  those  that  live  in  an  Air  thin  and  sharp,  or  very  thick 
and  foggy.    As  also  such  as  live  on  a  salt,  sower,  or  viscid  Diet. 

Want  of  Exercise  is  often  the  Cause  of  this  Acidity:  And  external 
Accidents,  such  as  Blows,  Bruises,  Compressions,  &c.  are  frequently 
the  remote  Causes  of  the  Scrophula;  but  they  always  suppose  a  Predis- 
position in  the  Habit  towards  that  Disease.  Strains  also  of  the  Joints, 
such  as  the  Knee,  Ankle,  &c.  often  produce  visible  Symptoms  of  the 
Struma,  viz.  either  Glandulous  Tumours  in  the  Neck,  or  Tumours  in  the 
Bones,  which  terminate  in  a  Caries,  or  Spina  Ventosa.  A  remarkable 
Instance  of  a  Scrophula  produced  from  Compression,  I  had  Occasion  once 
to  observe  in  a  Cook's  Servant  in  the  Old-Baily,  who  by  sleeping  one 
Night  on  a  Form,  with  his  Head  reclined  over  it,  his  Neck  was  so  com- 
pressed with  the  End  of  the  Bench,  that  when  he  awaked,  it  was  full  of 
Strumae  on  both  Sides,  some  of  which  were  as  large  as  Walnuts;  and  tho* 
all  Means  were  used  that  cou'd  be  thought  of  by  the  ablest  Physicians 
and  Surgeons  for  his  Relief,  yet  in  a  few  Days  they  apostemated,  and 
became  virulent  Ulcers,  and  he  died  tabid  within  half  a  Year  after.  Too 
tight  Stays  have  often  the  same  Effect.  A  Pain  in  the  Breast  will  occasion 
scrophulous  Tumours  in  the  Axillae;  and  in  ill  Habits  of  Body,  a  sore 
Leg  hath  often  produced  such  like  Tumours  in  the  Groins. 


3i4  PEDIATRICS  OF  THE  PAST 

The  Parts  usually  affected  in  this  Disease  are  either  the  Glands, 
Muscles,  Viscera,  Membranes,  Tendons,  or  Bones.  I  don't  remember 
ever  to  have  seen  the  Nerves  or  Brain  immediately  affected  with  it;  or 
if  they  are,  it  does  not  appear  in  the  Shape  of  a  Tumour,  but  rather  dis- 
solves and  corrodes  them,  as  it  does  the  Marrow  and  Bones;  in  which 
Case  the  Disease  gets  another  Name,  and  being  mortal  needs  to  be 
insisted  on  here. 

The  Veins  and  Arteries  are  no  otherwise  affected  here,  then  they  are 
in  other  Cases  of  Tumours. 

The  Glands  are  the  principal  Seat  of  this  Distemper,  insomuch  that 
most  Authors  have  confined  it  to  them  intirely.  They  indeed  are  most 
commonly  affected  in  strumous  Patients;  and  if  the  external  and  more 
visible  ones  remains  whole,  yet  generally  speaking  the  internal  Glands, 
especially  those  of  the  Mesentery,  are  swelled  and  obstructed.  Of  these  I 
have  seen  many  different  Examples,  especially  in  Children,  and  have 
passed  my  Judgment,  that  they  have  been  strumous  when  the  external 
Signs  were  not  quite  so  evident  as  to  make  others  believe  it;  yet  it  hath 
appeared  upon  Dissection,  that  I  was  in  the  right.  Nay,  whenever  the 
external  Glands  appear  swelled,  we  may  safely  conclude  those  of  the 
Mesentery  to  be  so  too,  that  being  usually  the  first  Part  that  is  attacked 
in  this  Disease.  Nor  is  this  peculiar  to  the  Mesentery  alone,  but  likewise 
all  the  conglobate  Glands  suffer  along  with  it,  as  is  evident  in  those  of  the 
Groin,  Axillae,  &c.  but  no  where  more  frequently  than  in  the  Neck. 
Nor  are  the  conglomerate  Glands  exempted  from  the  same  Malady, 
such  as  the  Glandulae  Salivales,  Tonsillae,  Lachrymales,  the  Thymus, 
the  Pancreas,  the  Mammae,  the  Testicles,  Prostatae,  &c. 

These  are  sometimes  affected  together  with  the  conglobate  Glands, 
sometimes  separately.  In  some  we  have  found  all  the  Conglobate  Glands 
of  the  Neck  swelled,  and  many  of  them  pressing  hard  upon,  and  between 
the  Salivals;  yet  they  remained  sound. 

So  likewise  the  Pancreas  and  Thymus  have  been  surrounded  with 
Strumae,  while  they  themselves  have  remained  unaffected.  But  very 
often  the  Conglomerate  Glands  suffer  by  themselves,  as  in  the  Ranula, 
which  is  a  Tumour  of  the  Glandula  Salivalis  inferior.  The  Parotis  also, 
or  the  external  Salival  Gland,  is  very  often  preter-naturally  affected: 
And  in  the  Pancreas,  the  learned  Dr.  Needham  says,  he  had  seen  a 
strumous  Tumour  suppurated,  which  held  a  Pint  of  Matter,  while  the 
Glands  of  the  Mesentery  remained  quite  sound. 

That  the  Breasts  are  evidently  subject  to  the  Scrophula,  sufficiently 
appears  from  common  Experience. 

I  can  give'  no  Instance  of  this  Disease  in  the  Testicles  or  Prostatae; 
but  perhaps  this  may  be  owing  to  our  generally  suspecting  another 
Distemper,  when  these  Parts  come  to  be  affected  with  Tumours. 


RICHARD  WISEMAN  315 

That  the  Tonsillae  are  frequently  strumous,  is  known  to  every  one 
that  is  acquainted  with  this  Disease. 

The  Glandulae  Lachrymales  too,  are  affected  with  it,  and  according 
to  their  various  Disorders,  produce  various  kinds  of  Tumours  about  the 
Eye;  the  most  usual  of  which  is  the  Lippitudo,  the  Hordeoli,  &c.  nay, 
sometimes  the  whole  Eye-Ball  is  thrust  out  of  its  Socket,  by  the  Swelling 
of  those  Glandules. 

The  Ophthalmia  too  is  often  a  Consequence  of  the  Disease,  and  the 
Fistula  Lachrymalis  is  frequently  derived  from  it. 

Besides  all  these,  the  Glands  dispersed  in  the  several  Interstices  of 
the  Muscles  are  frequently  rendered  strumous;  as  in  the  Arms,  the 
Legs  and  Feet,  nay  the  very  Fingers  and  Toes  too,  are  affected  with  the 
same. 

In  a  Child  of  six  Years  old,  I  saw  them  spreading  all  over  the  Body; 
some  superficial  in  the  Skin,  others  deep. 

The  Viscera  are  often  found  with  great  Strumae  growing  in  them,  or 
from  them.  Thus  we  find  the  Liver,  Lungs  and  Spleen,  frequently  stru- 
mous, and  sometimes  weighed  down  with  scrophulous  Appendages. 
Dr.  Walter  Needham  declared  in  one  of  his  late  Anatomical  Lectures  at 
our  Hall,  that  he  had  seen  a  strumous  Swelling  hang  at  the  Cone  of  the 
Heart  that  weight  two  Ounces. 

The  Tendons  likewise  are  sometimes  involved  with  a  great 
Gumminess  and  Collection  of  strumous  Matter,  especially  the  Fingers, 
Hands,  Feet  and  Toes;  nay,  upon  the  Musculus  Mastoideus  itself,  we 
find  them  very  distinguishable  from  glandulous  Tumours,  and  hard  to 
be  managed.  The  Elbows,  Knees,  and  Ancles,  are  very  remarkable  Seats 
of  this  Species  of  the  Disease. 

The  Bones  are  as  frequently  affected  as  any  Part  of  the  Body, 
the  Glands  only  excepted;  but  there  the  Manner  of  the  Tumour  differs; 
for  though  the  Bone  swell,  and  the  external  cortical  Part  appear  hard, 
yet  all  within  is  found  putrid  and  rotten.  This  Sort  of  Tumour  is  some- 
times termed  Spina  Ventosa;  but  how  far  that  Term  is  proper  I  leave 
others  to  judge.  This  I  can  affirm,  that  all  the  Bones  of  the  Body  are 
subject  to  this  Evil,  the  Skull  itself,  and  Jaw-Bones  not  excepted. 

The  Bones  likewise  affected  in  their  Outside  by  any  scrophulous 
Tumour  that  happens  to  touch  them,  whether  in  Membrane  or  Tendon, 
&c.  which  we  often  experience  in  opening  them,  when  they  lie  near  such 
Parts:  For  when  we  do,  we  most  commonly  find  the  Bone  itself  bare,  if 
not  carious.  The  Oezaena  is  often  a  scrophulous  Case. 

As  to  the  Differences  of  the  Strumae;  they  are  sometimes  more  mild, 
without  Inflammation  or  Pain,  and  moderately  hard,  but  by  Access  of 
Heat,  inflame  and  suppurate;  as  well  those  of  a  round  Figure,  which  is 
esteemed  the  best  and  mildest  Sort,  as  those  of  any  other.  Some  of  the 


3i6  PEDIATRICS  OF  THE  PAST 

mildest  and  biggest  Strumae,  I  have  seen  perfectly  suppurated  without 
Change  of  Colour  in  the  Skin,  but  after  some  Days  they  again  become 
hard  as  before.  When  they  suppurate  with  Inflammation,  then  there  is  a 
Mixture  of  Blood  with  them,  and  they  are  called  Phlegmonoides;  others 
are  indurated,  and  after  a  while  become  schirrous,  yet  sometimes  by 
a  putrid  Heat  grow  painful,  and  soft  in  the  upper  Part;  which  Softness 
hath  by  some  been  mistaken  for  a  Suppuration,  but  at  their  Opening 
they  only  ooze  out  a  thin  Matter,  and  at  length  too  frequently  shew 
their  malign  Quality,  by  terminating  in  one  of  the  Species  of  a  Cancer. 

Other  Differences  may  be  taken  Notice  of,  viz.  that  some  are  primi- 
genial,  as  when  the  Disease  is  Original;  and  Secondary,  when  it  succeeds 
some  other  Disease,  as  particularly  a  Fever,  which  often  terminates  in  a 
Congestion  of  Matter.  It  also  sometimes  happens  after  Catarrhs  and 
other  Distempers.  There  are  likewise  some  by  sudden  Fluxion,  other  by 
long  Congestion. 

The  Steatoma,  Atheroma,  and  Meliceris,  as  they  are  the  frequent 
Companions  of,  so  they  are  often  not  easily  distinguishable  from  these 
Tumours. 

THE  DIAGNOSTICK  SIGNS 

The  Signs  of  the  Tumours  will  be  more  difficultly  given,  by  Reason  of 
the  various  Shapes  in  which  they  appear. 

When  it  affects  a  Conglobate  Gland,  the  Tumour  is  usually  round, 
moderately  hard,  and  moveable  without  Pain.  Those  of  an  oval  Figure, 
which  are  hard,  and  accompanied  with  Pain  without  Inflammation,  are 
of  an  ill  Quality;  and  if  they  grow  unequal,  they  threaten  a  Cancer. 
When  a  Conglomerate  Gland  is  the  Seat  of  it,  it  usually  observes  the 
Shape  of  that  Gland,  especially  if  the  whole  Gland  be  diseased:  But  it  is 
not  unfrequent  to  see  some  of  those  lesser  Glandulae,  or  Kernels,  swell 
into  oval,  round,  flat  or  other  Figures,  while  Part  of  their  Substance 
remains  sound  enough. 

In  a  Muscle  the  Shape  is  uncertain,  and  always  distinct  from  the 
Muscle;  the  Tumour  harder  or  softer  as  it  happens;  but  those  of  a  round 
Figure  are  the  most  benign. 

The  Lip  when  infected  is  commonly  thick  and  chopt. 

Bones  when  strumous  swell,  grow  hard  and  big;  but  if  you  open  them 
they  are  found  inwardly  rotten,  as  hath  already  been  hinted. 


THE  PROGNOSTICKS 

In  the  Prognostick  you  are  to  consider,  whether  the  Tumours  be  many 
or  few,  grown  together  in  Clusters  or  more  distinct,  great  or  small,  deep 
or  superficial,  moveable  or  immoveable,  benign  or  malign,  soft  or  hard: 


RICHARD  WISEMAN  317 

The  Place  of  them,  whether  near  great  Vessels,  Joints,  Nerves,  Tendons 
or  Bones;  and  the  Habit  of  the  Body  is  to  be  considered;  also  the  Age  of 
the  Patient. 

If  the  Habit  of  Body  be  tolerable,  the  Patient  young,  the  Strumae 
recent  and  but  moderately  hard,  the  Resolution  or  Suppuration  of  them 
may  be  accomplished:  But  if  they  have  been  of  long  Continuance,  are 
hard  and  lie  deep  amongst  the  Vessels,  the  Work  is  difficult;  yet  the  Cure 
of  both  is  very  often  furthered  by  accidental  Ferments,  which  will  resolve 
them  to  a  Wonder,  and  as  often  suppurate  them.  If  the  Struma  be  move- 
able, and  not  attached  to  any  considerable  Blood-vessels,  the  Extirpa- 
tion is  not  difficult;  but  if  the  Habit  of  Body  be  bad,  and  the  Strumae 
immoveable,  they  are  not  to  be  meddled  with.  Tho'  they  be  moveable, 
yet  if  they  lie  deep  amongst  the  largest  Vessels,  the  Extirpation  is  dan- 
gerous: Besides  even  in  the  best  Habits  of  Body,  new  Strumae  are  apt 
to  arise,  while  you  are  extirpating  the  old  Ones. 

If  the  Strumae  have  been  long  ulcerated,  and  become  sinous  and 
virulent,  and  if  they  lie  near  one  another,  they  often  find  a  Communi- 
cation with  one  another,  though  to  the  Eye  they  may  seem  distinct:  In 
which  Case  the  Lips  grow  callous,  the  Ulcers  become  corrosive,  and 
frequently  sordid,  and  the  Cure  is  not  to  be  hoped  for,  as  long  as  one 
Cystis  remains,  or  the  Vessels  that  feed  them.  But  if  the  Ulcerations  be 
Simple,  the  Cure  is  accordingly  easy. 

They  who  are  seized  with  Strumae  in  the  Neck  after  forty  Years  of 
Age  seldom  recover,  such  generally  labouring  under  great  Obstructions, 
whence  spring  scorbutical  Affections,  Jaundice,  Fainting,  Vomiting,  Loss 
of  Appetite,  and  sometimes  a  Dropsy;  in  some  a  Cough,  in  which  case 
they  die  tabid. 

If  strumous  Tumours  or  Gummata  arise  from  a  Caries  in  the  Bones 
of  the  Fingers  or  Hands,  the  Case  will  require  great  Care;  if  in  the  Foot 
or  Toes,  it  will  be  more  difficult;  if  in  the  Os  Calcis,  Joint  of  the  Ankle,  or 
Astragalus,  or  in  the  Knee-Bones,  or  Ischia,  &c.  where  you  cannot  lay 
them  open,  or  indeed  judge  of  the  Rottenness,  the  Case  is  deplorable, 
and  the  Work  tedious.  The  very  Discharge  of  the  Matter  exhausting  the 
Spirits  of  the  Patient,  so  that  they  generally  die  of  a  Marasmus :  But  if 
by  Strength  of  Body,  and  the  Help  of  Medicines,  the  Ulcers  digest, 
sometimes  the  rotten  Bones  moulder  and  exfoliate,  and  the  Member 
is  supplied  with  a  new  Callus,  as  you  may  sometimes  observe;  but  the 
Case  is  always  dangerous. 

If  strumous  Ulcers  or  Gummata  outwardly  foul  the  Bones,  if  the 
Habit  of  body  be  tolerably  good,  and  the  Ulcers  well  handled,  the 
Patient  may  recover;  but  if  the  Habit  be  bad,  new  Ulcers  arise,  so  that 
the  Cure  is  long  and  difficult. 


318  PEDIATRICS  OF  THE  PAST 

THE  CURE 

In  the  Cure  of  the  King's-Evil,  you  must  consider  the  Habit  of  Body, 
Strength  and  Age  of  the  Patient,  the  State  of  the  Viscera,  and  particu- 
larly whether  the  Struma  be  Simple  or  Complicated. 

In  order  to  the  Cure,  three  Intentions  are  to  be  followed.  The  first 
consists  in  the  Regimen  of  the  Diet,  and  the  other  Non-naturals;  the 
Second  in  Pharmacy  or  internal  Prescriptions;  the  Third  in  the  Appli- 
cation of  Externals,  either  to  discuss,  suppurate  or  extirpate  the  diseased 
Glands. 

In  the  first  concerning  a  general  Regimen  of  Diet,  &c.  there  ought  to 
be  special  Regard  had  to  the  Constitution  of  the  Patient,  whether  he  be 
hot  or  cold,  dry  or  moist,  old  or  young,  robust  or  tender  and  washy. 
If  the  Body  be  cold  and  moist,  we  generally  suppose  too  great  an  Indul- 
gence in  Eating  and  Drinking  to  have  preceded,  and  Crudity  to  abound; 
in  which  Case  the  best  Way  is  to  live  abstemiously.  The  Diet  ought  to 
be  moderately  heating  and  drying,  Mutton,  Kid,  Rabbit,  Pullet, 
Chicken,  Partridge,  Pheasant,  Cock,  &c.  and  these  roasted;  avoiding  all 
Meats  which  yield  a  gross  Nourishment,  such  as  Water-Fowl,  Fish  and 
Herbs;  their  Bread  ought  to  be  of  Wheat  and  well-baked,  and  their 
Drink  medicated  Ale  or  Beer;  Wine  is  also  allowed,  but  Water  utterly 
forbidden. 

In  hot  and  dry  Bodies  inclining  to  be  hectick,  we  allow  a  more 
moistening  Diet,  their  Meat  boiled  with  Lettice,  Spinage,  Purslain, 
Wood-Sorrel,  &c.  To  some  of  these  we  dare  scarce  permit  the  eating  of 
Flesh;  but  rather  a  Milk  Diet  of  Asses  Milk;  but  where  Milk  doth  not 
agree,  we  prescribe  them  medicated  Broths. 

Air  is  a  great  Help  in  the  Cure:  In  cold  Constitutions  it  ought  to  be 
moderately  heating  and  attenuating,  in  hot  Ones  cooling;  in  neither  too 
piercing,  as  that  of  Hampsted  is;  in  which  Sort  of  air  there  is  always 
something  esurine  and  acid;  but  rather  mild  and  gentle,  as  that  fof 
Kensington:  and  if  the  Air  be  equally  mild,  the  farther  removed  from  the 
Smoke  of  the  City,  the  better. 

Exercise  ought  to  be  enjoined;  sleeping  in  the  Day-Time  is  forbidden, 
unless  in  Case  of  Pain,  to  which  it  is  an  Anodyne;  the  Passions  of  the  Mind 
ought  also  to  be  moderated. 

The  second  Intention  consisting  in  the  Use  of  Medicines;  they  must 
be  adapted  to  the  Habit  of  Body.  If  it  be  cold  and  phlegmatick, 
abounding  with  gross  viscid  Humours,  your  Prescriptions  ought  to  be 
heating  and  attenuating:  In  Plethorick  Bodies  you  must  purge  with  the 
stronger  Catharticks,  or  repeat  the  milder  often,  otherwise  the  Disease 
will  be  apt  to  increase  under  your  Hand.  The  proper  Purgatives,  are 
Species  Hierae  cum  Agaric,  Diaturb.  Pulv.  Cornocbin.  Pil.  Cocbiae, 


RICHARD  WISEMAN  319 

e  duobus,  Rudii,  Hermodact.  Aleopbang.  Imperial,  e  Succino;  Trocbise. 
Albandal  Diagris.  Resina  Jalapii,  &  Mercur.  Dulcis.  and  all  those  Medi- 
cines prescribed  in  the  Lues  Venerea.  For  Example. 

Take  Rudius's  Extract,  one  Scruple. 

Calomel,  fifteen  Grains. 

Oil  of  Sassafras,  three  Drops. 

Mix  for  a  Dose  to  be  taken  in  the  Morning. 

Alteratives  are  also  useful,  those  Days  they  do  not  purge,  of  which 
Sort  the  following  is  very  much  commended. 

Take  of  Burnt  Sponge, 

Bone  of  the  Scuttle- Fish, 

Long  Pepper, 

Black  Pepper, 

Cardamoms, 

Ginger, 

Salt  Gemm, 

Pellitory, 

Cypress  Nuts, 

Galls,  of  each  two  Ounces. 

Make  them  into  a  Powder. 

He  is  to  chew  some  of  it  daily,  and  swallow  it  down  insensibly. 
For  ordinary  Drink  he  may  use  the  following  Decoction. 

Take  of  China  Root,  two  Ounces. 

Sarsaparilla,  six  Ounces. 
AH  the  Saunders,  three  Drachms. 

Sassafras,  ten  Drachms. 

Infuse  them  in  eight  Pounds  of  Spring-Water  for  twelve  Hours,  and 
then  add 

Of  the  Leaves  of  Agrimony,  two  Handfuls. 

Fluelline,  three  Handfuls. 

Scabious,  one  Handful. 

Seeds  of  Sweet  Fennel. 

Of  Carvy,  of  each  three  Drachms. 

Stoned  Raisins  of  the  Sun,  six  Ounces. 

Boil  them  till  a  Third  Part  of  the  Liquor  be  consumed,  and  then  strain 
it.   .    .    . 

In  Order  to  the  suppurating  of  them  it  is  common  to  pinch  them 
hard;  I  have  seen  some  People  in  the  Country  thrust  a  Thorn  into  them, 
and  thereby  raise  an  Inflammation,  which  soon  disposes  them  to  sup- 


320  PEDIATRICS  OF  THE  PAST 

purate.  Before  you  open  them,  you  must  endeavour  at  a  perfect  Concoc- 
tion ;  for  if  you  open  them  while  any  Part  of  the  Cland  is  hard,  it  will 
increase  and  put  you  upon  a  Necessity  of  eradicating  it,  or  of  leaving 
your  Cure  imperfect.  As  to  the  Way  of  opening  them  when  suppurated, 
that  by  Incision  makes  the  least  Scar;  but  if  the  Struma  be  large,  they 
Way  by  Caustick  is  more  certain.  The  Matter  being  discharged,  you 
may  deterge  with  Mundific.  Paracels.  Precipitate,  and  the  Vitriol-Stone, 
and  afterwards  incarn  and  cicatrize,  as  in  crude  Abscesses. 

But  in  the  old  and  hard  Strumae,  we  are  seldom  able  to  obtain  a 
complete  Suppuration;  sometimes  during  the  Application  of  the  most 
subtle  Discutients,  we  raise  a  Heat  in  the  Skin,  which  affecting  the 
Cystis  and  part  of  the  Gland  next  it,  causeth  an  imperfect  Suppuration; 
by  the  continued  Use  of  the  Discutients  the  Matter  at  length  frets  its 
Way  through  in  small  Apertures,  which  if  you  continue  those  Applica- 
tions, grow  bigger,  and  become  so  many  painful  Ulcers  spreading  one 
into  another;  the  Body  of  the  Gland  remaining  hard  without  Hopes  of 
Suppuration.  But  if  you  dress  them  two  or  three  Days  with  a  Pledget 
dipt  in  Basilicon,  you  may  qualify  the  Heat,  and  moderate  the  Ulcer- 
ation; and  so  by  interchangeably  applying  the  Discutient,  or  Lenient, 
you  may  happily  waste  the  whole  Gland,  if  the  Patient  be  treated  in  the 
mean  while  by  proper  Internals.  In  some  of  those,  who  have  come  to  me 
out  of  the  Country  with  ulcerated  Strumae  about  the  Chops,  I  have 
seen  the  Struma  thrust  forth  in  a  Fungus;  so  that  with  my  Spatula 
passing  under  them,  I  have  thrust  them  quite  out,  and  healed  the  Ulcer 
in  a  few  Days:  In  others  where  they  are  incapable  of  being  so  thrown  out, 
I  cut  off  the  protuberant  Part,  and  consumed  the  remaining  Basis  with 
Escaroticks. 

If  the  Struma  be  moveable,  and  do  not  adhere  to  any  considerable 
Blood  Vessels,  the  speediest  Way  of  Cure  is  by  cutting  the  Skin,  and 
taking  them  out  whole  with  their  Cystis :  Those  which  have  Stalks  and 
are  pendulous,  or  grow  small  near  the  Basis,  may  be  tied  and  cut  off: 
Of  this  Sort  we  see  many. 

In  those  which  are  so  thick  in  the  Basis  that  you  cannot  make  a 
Ligature  on  them,  you  may  pass  a  proportionable  Needle  under  the 
Roots  of  them,  and  cut  them  off  under  the  Needle. 


w 


THOMAS  SYDENHAM 

[1624- 1 689] 

HEN  a  man  has  his  name  used  to  designate  a  hospital 
three  hundred  years  after  he  has  lived  and  over  three 
thousand  miles  from  where  he  was  born,  it  must  mean  that 
he  did  something  to  impress  his  name  on  the  roll  of  the  years. 
Thomas  Sydenham  was  such  a  man.  It  is  related  that  Boerhaave 
held  his  memory  in  such  esteem  that,  when  lecturing,  he  always 
removed  his  hat  when  he  mentioned  Sydenham's  name.  Some  day 
someone  will  write  his  life  and  make  him  live  over  again  for  us.  As 
it  is,  the  amount  of  biographical  material  must  be  sufficient. 
Payne  has  gone  over  the  facts  of  his  life  as  far  as  they  are  known 
and  written  a  delightful  story  of  his  life  and  works,  and  there  is  a 
dull  account  of  him  by  Latham  preceding  the  translation  of  the 
Greenhill  edition.  There  is,  too,  a  short  life  by  George  Wallis  in  the 
1788  edition,  and  Frederic  Picard  has  given  a  rather  full  account, 
especially  valuable  for  the  long  list  of  references  and  the  lists  of  the 
Sydenham  publications.  Various  writers  have  sketched  his  life  or 
works,  notably  John  Brown,  in  the  essay  called,  "Locke  and 
Sydenham,"  in  the  "Horae  subsecivae."  Sydenham  was  a  notable 
physician  and  while  we  are  concerned  with  him  more  as  a  pediat- 
rist,  it  may  not  be  out  of  place  to  take  a  glance  at  the  man 
himself. 

Born  in  an  ivy-grown  house  (which  Payne  says  is  still  standing) 
at  Wynford  Eagle,  a  hamlet  in  Dorsetshire,  of  a  Puritan,  Parlia- 
mentary family,  Sydenham  was  baptized  September  10,  1624. 
The  Sydenham  family  dates  back  to  the  time  of  King  John  and 
eventually  divided  into  various  branches  which  have  furnished 
its  quota  of  divines  and  jurists,  but  found  its  finest  flower  in  the 
physician,  Thomas.  Of  his  early  life  we  know  little  but  that  he 
was  brought  up  in  an  educated,  dignified  family.  When  eighteen 
he  was  matriculated  as  a  Fellow  Commoner  in  Magdalen  Hall, 
Oxford.  This  was  in  1642.  Political  events  were  moving  rapidly 

321 


322  PEDIATRICS  OF  THE  PAST 

at  this  time  and  the  young  Sydenham  found  his  studies  cut  short 
by  the  Civil  War,  the  rupture  of  King  and  Parliament.  Sir 
Anthony  Wood  says  that  Sydenham  left  Oxford  without  taking 
arms  for  the  King,  as  other  scholars  did.  With  his  early  training 
it  had  been  strange  if  he  had  served  under  the  King's  standard. 
Doughty  deeds  are  set  down  to  the  Sydenhams  in  civil  war  as  it 
was  carried  on  in  Dorsetshire.  William,  his  eldest  brother,  became 
a  colonel  and  follower  of  Cromwell;  two  other  brothers  were 
majors:  both  killed  in  action;  while  his  mother  is  said  to  have 
been  killed  by  the  Royalists  and  an  old  narrative  relates  how  the 
eldest  son  afterwards  slew  the  man  who  did  it.  In  the  defense  of 
Weymouth,  Thomas  was  slightly  wounded.  Curiously  enough,  on 
the  opposing  side  was  Richard  Wiseman,  "the  father  of  English 
surgery." 

In  1646,  Sydenham  returned  to  Oxford.  The  letter  of  dedica- 
tion in  the  third  edition  of  his  "Observationes  Medicae"  tells  how 
in  London,  on  his  way  to  Oxford,  he  fell  in  with  Dr.  Thomas 
Coxe,  at  that  time  attending  his  brother,  and  was  persuaded  to 
study  medicine.  Oxford  was  a  troublous  place  that  year,  the 
Royalists  members  to  the  number  of  several  hundred  being  driven 
out  by  Parliament.  Sydenham  enrolled  as  a  fellow  commoner  of 
Wadham  College.  He  evidently  took  the  degree  of  m.  a.  and  was 
"created"  a  bachelor  of  medicine  by  the  command  of  the  Earl  of 
Pembroke  on  April  14,  1648.  This  ordering  of  degrees  was  not 
unheard  of.  Wharton,  the  anatomist,  received  his  degree  by  "  crea- 
tion" and  John  Shaw,  the  medical  poet  of  Maryland,  and  some 
associates  were  actually  made  m.  d.  by  act  of  the  General  Assembly 
of  Maryland.  But  to  return  to  Sydenham.  He  received  a  fellowship 
in  All  Souls'  College  and  was  later  appointed  senior  bursar.  The 
opportunities  for  the  study  of  medicine  were  not  great:  a  little 
of  the  classics,  a  bit  of  chemistry  and  some  anatomy,  but  no 
clinical  facilities.  There  is  evidence  that  Sydenham  left  Oxford  a 
second  time  to  become  a  captain  of  cavalry.  About  this  time  he 
narrowly  escaped  being  shot  by  a  drunken  soldier,  as  related 
by  a  Scotch  physician,  Dr.  Andrew  Brown.  In  1653-54,  six  hun- 
dred pounds  were  paid  to  Sydenham  by  the  Commonwealth,  being 
money  due  his  brother  John,  killed  in  Scotland.  Some  time  in 
the  year  1665  he  resigned  his  fellowship  in  AH  Souls'  College 
and  the  same  year  it  is  recorded  in  the  Archives  at  Wynford 
Eagle  that  he  married  Mary  Gee. 


Thomas  Sydenham 
[1624- 1 689] 


THOMAS  SYDENHAM  323 

Of  the  years  in  London  and  his  practice  there,  we  know  little 
except  that  he  settled  in  Westminster,  close  by  the  Government 
offices,  and  not  far  from  the  poet  Milton,  at  that  time  Latin 
secretary  to  the  Council  of  State.  Beyond  lay  the  malarious  swamp, 
now  St.  James*  Park;  little  wonder  that  he  wrote  of  agues,  the 
malady  that  carried  off  the  great  Protector  himself.  He  must 
have  dabbled  in  politics  at  this  time,  as  he  was  made  "Comptroller 
of  the  Pike"  in  1659;  but  with  the  Restoration  the  following  year, 
he  could  not  have  held  the  office  long. 

At  this  time  there  was  in  Montpellier  Charles  Barbeirac,  a 
Protestant,  and  therefore  ineligible  to  a  professorship  in  the 
University.  He  had,  however,  a  great  following,  giving  clinical 
lectures,  as  the  French  have  always  done  with  much  charm  and 
grace.  Thither  it  appears  Sydenham  repaired  and  must  have 
profited.  Later,  when  his  friend  Locke  visited  Montpellier  he 
was  struck  by  the  similarity  of  the  two  men. 

Returning  to  London,  doubtless  about  1661,  he  was  admitted 
a  licentiate  of  the  College  of  Physicians  on  June  25,  1663.  It  is 
highly  probable  that  the  course  of  Sydenham's  professional  life 
ran  none  too  smoothly.  John  Brown,  in  his  account,  "Dr.  Andrew 
Brown  and  Sydenham,"  quotes  the  Scotsman  on  this  point:  "He 
had  only  gained  the  sad  and  unjust  recompense  of  calumny  and 
ignominy,  and  that  from  the  emulation  of  some  of  his  Collegiate 
brethren,  and  others,  whose  indignation  at  length  did  culminate 
to  that  height,  that  they  endeavoured  to  banish  him,  as  guilty  of 
medicinal  heresies,  out  of  that  illustrious  Society."  But  he  was  on 
good  terms  with  many  of  the  fellows,  a  title  which  he  never 
himself  attained.  The  expressions  used  in  the  licenses  to  print  his 
work  are  most  commendatory,  climaxing  in  the  treatise  on  gout  in 
"Donatus  ab  autore  praestantissimo." 

In  1664  came  the  Great  Plague  when,  asPepys  puts  it,  "All 
the  town  almost  going  out  of  town,"  and  with  them  Sydenham. 
Why  is  not  clear,  but  probably  to  protect  his  growing  family, 
though  as  Payne  states,  "all  his  paying  patients  leaving  must 
have  cut  off  his  income."  This  industrious  biographer  goes  on  to 
state  that  the  fee  at  that  time  was  about  ten  shillings  (an  angel). 
Many  the  jests  at  the  expense  of  the  physicians!  "Culpepper,  the 
herbalist  and  quack,  had  a  bitter  gibe  that '  Physicians  of  the  pres- 
ent day  are  like  Balaam's  ass,  they  will  not  speak  until  they  see 
an  angel.'"  Had  Sydenham  remained,  his  writings  on  the  plague 


324  PEDIATRICS  OF  THE  PAST 

might  have  added  still  more  to  his  fame,  but  alas!  he  did  not 
stay.  There  were  two  chief  points  of  view  regarding  the  plague 
at  that  time:  one,  that  it  was  due  to  local  conditions,  the  other 
that  it  was  due  to  contagion.  Sydenham  held  chiefly  to  the 
former  view. 

Sydenham's  views  of  epidemics  are  coming  to  the  fore  again, 
another  fascinating  example  of  the  reappearance  of  certain  medical 
ideas.  Ernst  Mach,  the  great  Viennese  thinker,  and  F.  G.  Crook- 
shank,  among  others,  have  voiced  and  amplified  this.  Crookshank 
thinks  that  while  a  single  case  of  disease  may  be  traced  to  a 
contagium  vivum,  an  epidemic  is  of  multiple  causation.  He  uses 
the  illustration  of  the  war,  the  deaths  caused  by  bullets  and 
shrapnel,  but  the  underlying  causes  remote  from  either. 

While  away,  Sydenham  wrote  his  first  medical  work.  After 
the  manner  of  the  time  it  was  written  in  Latin.  Whether  Sydenham 
actually  wrote  Latin  is  a  disputed  point  and  everyone  interested 
will  do  well  to  read  Payne's  sprightly  chapter  on  this  point. 
Sydenham  probably  read  Latin  easily,  but  it  is  usually  assumed 
that  he  wrote  in  English  and  had  his  good  friend,  Dr.  Maplefoot, 
or  Mr.  Havers  translate  it  into  Latin. 

His  first  book  is  one  of  great  interest,  "Methodus  Curandi 
Febres,  propriis  observationibus  superstructa "  (Thomas  Syden- 
ham's "Methods  of  Treating  Fevers,  Based  on  His  Own  Observa- 
tions"). This  is  a  small  octavo  of  156  pages.  It  is  dedicated  to 
the  Honorable  Robert  Boyle.  One  paragraph  is  well  worth 
quoting,  his  via  vitae,  as  it  were. 

Whoever  applies  himself  to  medicine  ought  seriously  to  weigh  the 
following  considerations.  First,  that  he  will  one  day  have  to  render  an 
account  to  the  Supreme  Judge  of  the  lives  of  sick  persons  committed 
to  his  care.  Next,  whatever  skill  or  knowledge  he  may,  by  the  Divine 
favour,  become  possessed  of,  should  be  devoted  above  all  things  to  the 
glory  of  God  and  the  welfare  of  the  human  race.  Moreover,  let  him 
remember  that  it  is  not  any  base  or  despicable  creature  of  which  he  has 
undertaken  the  cure.  For  the  only  begotten  Son  of  God,  by  becoming 
man,  recognised  the  value  of  the  human  race,  and  ennobled  by  His 
own  dignity  the  nature  He  assumed.  Finally,  the  physician  should  bear 
in  mind  that  he  himself  is  not  exempt  from  the  common  lot,  but  subject 
to  the  same  laws  of  mortality  and  disease  as  others;  and  he  will  care  for 
the  sick  with  more  diligence  and  tenderness  if  he  remembers  that  he 
himself  is  their  fellow-sufferer. 


THOMAS  SYDENHAM  325 

The  book  itself  is  in  four  parts:  (1)  "On  Continued  Fevers"; 

(2)  "On  Certain  Symptoms  Which  Accompany  Continued  Fevers"; 

(3)  "Intermittent  Fevers";  (4)  "Small-pox,  Which  Includes 
Measles."  A  second  edition  was  issued  in  1668  with  an  added 
chapter  on  the  plague,  and  a  long  Latin  poem  by  John  Locke. 
Payne  gives  an  extract  done  into  English. 

With  Fever's  heats,  throughout  the  world  that  raged, 
Unequal  war  has  mourning  Medicine  waged; 
A  thousand  arts,  a  thousand  cures  she  tries; 
Still  Fever  burns,  and  all  her  skill  defies, 
Till  Sydenham's  wisdom  plays  a  double  part, 
Quells  the  disease,  and  helps  the  failing  Art. 
No  dreams  are  his  of  Fever's  mystic  laws, 
He  blames  no  fancied  Humour  as  its  cause; 
Shunning  the  wordy  combats  of  the  Schools, 
Where  an  intenser  heat  than  Fever  rules. 
Thy  arms,  Victorious  Medicine!  more  intend, 
Triumphant,  thou,  the  unconquered  Plague  shalt  end, 
Live,  Book!  while  Fever's  vanquished  flames  expire, 
Thee  and  the  world  awaits  one  common  fire. 

Locke  and  Sydenham  planned  a  work  on  smallpox,  but  only  the 
preface  and  dedication  were  written.  Much  enlarged,  the  work  on 
fevers  was  reissued  in  1676  with  the  title  "  Observations  Medicae 
circa  Morborum  Acutorum  Historiam  et  Curationem."  A  fourth 
edition  appeared  in  1685  and  other  editions  were  printed  in 
Holland,  Strassburg  and  Geneva. 

Sydenham  has  been  called  the  English  Hippocrates,  a  title 
which  would  have  delighted  his  soul,  as  he  was  a  great  admirer 
of  the  old  Greek  and  had  little  esteem  for  any  other.  He  liked 
the  clinical  histories,  the  epidemics,  the  descriptions  at  first 
hand,  and  all  this  must  have  influenced  Sydenham  greatly.  He 
prided  himself  on  observing  things  for  himself  with  scant  regard 
for  written  authority.  Medicine  had  been  asleep  since  Galen.  The 
writings  were  largely  academic,  long-winded  discussions  in  which 
the  patient  and  his  disease  were  often  lost  sight  of  in  the  disputa- 
tions. Sydenham  studied  epidemics  and  fevers  and  described  what 
he  saw.  He  was  not  the  first:  Mayow,  Glisson  and  others  had  led 
the  way,  but  Sydenham  spoke  in  no  uncertain  tongue,  gaining  a 
hearing  which  the  greatest  genius  of  his  century,  John  Mayow, 


326  PEDIATRICS  OF  THE  PAST 

lacked.  Sydenham  was  influenced,  too,  by  Bacon,  Boyle  and  Locke. 
He  studied  disease  as  one  might  natural  history.  His  expositions 
make  hard,  sometimes  unintelligible,  reading;  and  his  arrangement 
under  the  epidemics  of  different  years  makes  it  all  the  more  diffi- 
cult. He  scorned  pathology,  had  little  use  for  anatomy  or  physiol- 
ogy, prided  himself  on  his  practical  turn  of  mind.  He  knew,  as 
Baas  says,  that  the  causes  of  things  are  inscrutable.  He  believed 
in  nature,  that  the  patient  would  get  well  through  natural  causes, 
a  view  as  old  as  Hippocrates.  Disease  to  him  is  "an  effort  of 
Nature,  striving  with  all  her  might  to  restore  the  patient  by  the 
elimination  of  morbific  matter." 

Much  has  been  written  about  Sydenham's  views  of  the 
epidemic  constitution.  Ballonius  formulated  it  (1574)  as  did  Hip- 
pocrates, perhaps,  first  of  all.  Sydenham  pointed  out  that  there 
were  long  periods  of  evolution,  with  a  rise  and  fall  and  shorter 
variations  from  month  to  month  and  from  year  to  year;  that  the 
secondary  manifestations  of  epidemics  varied  from  time  to  time, 
one  complication  being  more  prominent  at  one  time  and  another 
later.  All  this  is  being  remasticated  and  redigested  by  the  medical 
mouths  and  maws  of  the  present  day;  we  are  at  least  catching  up 
with  Sydenham  and  Hippocrates.  He  believed  that  certain  diseases 
would  disappear  and  that  others  would  take  their  place,  which  in 
the  centuries  since  his  writings,  has  been  abundantly  justified.  He 
also  regarded  pleurisy  and  pneumonia  as  a  general  inflammation 
of  the  blood  and  this  he  thought  true  of  other  diseases,  an  opin- 
ion amply  demonstrated  by  recent  bacteriologic  studies.  Of  his 
pragmatism  much  has  been  written;  of  book  theories  he  had  little 
use,  they  "have  as  much  to  do  with  treating  sick  men  as  the 
painting  of  pictures  has  to  do  with  sailing  ships." 

Among  the  other  contributions  of  Sydenham  are  certain 
letters  written  to  various  doctors,  a  short  treatise  on  dropsy  and 
gout,  the  latter  disease  most  graphically  described;  but  small 
wonder,  he  suffered  atrociously  from  gout  himself.  Sydenham, 
the  Roundhead,  loved  good  living;  Wiseman,  the  surgeon  of  the 
Cavaliers,  drank  only  water.  In  Sydenham's  last  work,  on  the 
appearance  of  a  new  fever,  appears  the  masterly  description  of 
chorea.  Some  have  sought  to  belittle  this,  but  it  is  easy  to  find 
fault  with  early  descriptions,  just  as  it  is  easy  to  recognize  certain 
diseases  after  some  one  has  described  them.  Chorea  is  often  called 
Sydenham's  chorea,  as  it  was  his  account  that  definitely  sepa- 


THOMAS  SYDENHAM  327 

rated  it  from  the  chorea  major,  or  St.  Vitus'  dance,  the  epidemic 
dancing  mania  of  the  Middle  Ages. 

on  st.  Vitus' s  dance 

This  is  a  kind  of  convulsion,  which  attacks  boys  and  girls  from  the 
tenth  year  to  the  time  of  puberty.  It  first  shows  itself  by  limping  or 
unsteadiness  in  one  of  the  legs,  which  the  patient  drags.  The  hand 
cannot  be  steady  for  a  moment.  It  passes  from  one  position  to  another 
by  a  convulsive  movement,  however  much  the  patient  may  strive  to  the 
contrary.  Before  he  can  raise  a  cup  to  his  lips,  he  makes  as  many  gesticu- 
lations as  a  mountebank;  since  he  does  not  move  it  in  a  straight  line, 
but  has  his  hand  drawn  aside  by  spasms,  until  by  some  good  fortune 
he  brings  it  at  last  to  his  mouth.  He  then  gulps  it  off  at  once,  so  suddenly 
and  so  greedily  as  to  look  as  if  he  were  trying  to  amuse  the  lookers-on. 

Sydenham  introduced  the  so-called  "cooling  method"  in  the 
treatment  of  smallpox,  used  bark  in  malaria,  and  made  what,  for 
a  couple  of  hundred  years,  was  known  as  Sydenham's  laudanum,  a 
liquid  preparation  not  unlike  our  wine  of  opium.  This  he  used 
so  freely  that  he  was  dubbed  "opiopbilus." 

Many  the  stories  of  the  man.  How  he  sat  at  his  open  window, 
pipe  in  mouth,  silver  tankard  at  hand,  when  a  thief  ran  off  with 
the  tankard  with  Sydenham  too  gouty  to  follow!  How  he  told 
Harris  and  Richard  Blackmore,  too,  that  the  best  book  to  begin 
the  study  of  medicine  was  Don  Quixote!  How  he  once  remarked 
that  "the  arrival  of  a  good  clown  exercises  a  more  beneficial 
influence  upon  the  health  of  a  city  than  that  of  twenty  asses 
laden  with  drugs."  How  Hans  Sloane,  the  virtual  founder  of  the 
British  Museum,  came  to  him  as  a  medical  student  bearing  a 
letter  of  introduction  describing  him  as  "a  ripe  scholar,  a  good 
botanist,  a  skilful  anatomist."  Sydenham  exclaimed:  "This  is 
all  very  fine,  but  it  won't  do — Anatomy — Botany.  Nonsense! 
Sir,  I  know  an  old  woman  in  Covent  Garden  who  understands 
botany  better,  and  as  for  anatomy,  my  butcher  can  dissect  a 
joint  just  as  well;  no,  young  man,  all  this  is  stuff:  You  must  go  to 
the  bedside,  it  is  there  alone  you  can  learn  disease."  Sloane  became 
one  of  Sydenham's  house  students  and  another  was  Thomas 
Dover,  physician,  buccaneer,  rescuer  of  Selkirk  the  original  of 
Robinson  Crusoe,  whose  name  comes  down  to  us  in  Dover's 
powder.  Sydenham  treated  him  for  smallpox  and  Dover  has  left 
the  account  of  it. 


328  PEDIATRICS  OF  THE  PAST 

On  December  29,  1689,  Sydenham  died  and  was  buried  in  St. 
James'  Church,  Westminster.  The  inscription  on  his  tombstone 
reads : 

Prope  hunc  locum  sepultus  est 

Thomas  Sydenham 

Medicus  in  omne  aevum  nobilis 

Notus  erat  a.  d.  1624 

Vixit  annos  65. 

A  physician  famous  for  all  time  as  the  inscription  says. 

A  few  words  about  Sydenham's  views  on  scarlet  fever  before 
reading  some  of  his  writings  on  the  subject.  He  is  generally 
credited  with  being  the  first  to  describe  and  name  the  disease. 
Payne  thinks  that  he  did  great  harm  by  his  description,  not 
describing  the  sore  throat.  He  also  did  not  recognize  that  it  is 
contagious.  Payne  also  believes  that  the  name  is  Italian  on  account 
of  its  spelling  and  pronounciation,  but  gives  no  further  reasons  for 
his  view. 

SCARLET  FEVER 

1.  scarlet-fever  (Scarlatina)  may  appear  at  any  season.  Never- 
theless, it  oftenest  breaks  out  towards  the  end  of  summer,  when  it  attacks 
whole  families  at  once,  and  more  especially  the  infant  part  of  them. 
The  patients  feel  rigors  and  shiverings,  just  at  they  do  in  other  fevers. 
The  symptoms,  however,  are  moderate.  Afterwards,  however,  the  whole 
skin  becomes  covered  with  small  red  maculae,  thicker  than  those  of 
measles,  as  well  as  broader,  redder,  and  less  uniform.  These  last  for  two 
or  three  days,  and  then  disappear.  The  cuticle  peels  off;  and  branny 
scales,  remain,  lying  upon  the  surface  like  meal.  They  appear  and  dis- 
appear two  or  three  times. 

2.  As  the  disease  is,  in  my  mind,  neither  more  nor  less  than  a 
moderate  effervescence  of  the  blood,  arising  from  some  other  exciting 
cause,  I  leave  the  blood  as  much  as  possible  to  its  own  despumation,  and 
to  the  elimination  of  the  peccant  materials  through  the  pores  of  the  skin. 
With  this  in  view,  I  am  chary  of  bloodletting  and  of  clysters.  By  such 
remedies,  I  hold  that  a  revulsion  is  created,  that  the  particles  inimical  to 
the  blood  become  more  intimately  mixed  therewith,  and,  finally,  that  the 
proper  movement  of  Nature  is  checked.  On  the  other  hand,  I  am  cau- 
tious in  the  use  of  cordials.  By  them,  the  blood  may  be  overagitated,  and 
so  unfitted  for  the  regular  and  equable  separation  in  which  it  is  engrossed. 
Besides  which,  they  may  act  as  fuel  to  fever. 


THOMAS     SYDENHAM  329 

I  hold  it,  then,  sufficient  for  the  patient  to  abstain  wholly  from  animal 
food  and  from  fermented  liquors;  to  keep  always  indoors,  and  not  to 
keep  always  to  his  bed.  When  the  desquamation  is  complete,  and  when 
the  symptoms  are  departing,  I  consider  it  proper  to  purge  the  patient 
with  some  mild  laxative,  accomodated'  to  his  age  and  strength.  By  treat- 
ment thus  simple  and  natural,  this  ailment — we  can  hardly  call  it  more — 
is  dispelled  without  either  trouble  or  danger:  whereas,  if,  on  the  other 
hand,  we  overtreat  the  patient  by  confining  him  to  his  bed,  or  by  throw- 
ing in  cordials,  and  other  superfluous  and  over-learned  medicines,  the 
disease  is  aggravated,  and  the  sick  man  dies  of  his  doctor. 

3.  This,  however,  must  be  borne  in  mind.  If  there  occur  at  the 
beginning  of  the  eruption  either  epileptic  fits,  or  coma — as  they  often  do 
occur  with  children  or  young  patients — a  large  blister  must  be  placed  at 
the  back  of  the  neck,  and  a  paregoric  draught  of  syrup  of  poppies  must 
be  administered  at  once.  This  last  must  be  repeated  every  night  until  he 
recover.  The  ordinary  drink  must  be  warm  milk  with  three  parts  water, 
and  animal  food  must  be  abstained  from. 


MEASLES  IN  THE  YEAR  167O 

i.  The  measles  set  in  early  as  usual;  i.  e.,  at  the  beginning  of  January. 
They  gained  strength  every  day,  until  they  reached  their  height,  about 
the  vernal  equinox.  After  this  they  gradually  decreased  at  the  same  rate; 
and  by  the  month  of  July  were  wholly  gone.  As  far  as  I  have  hitherto  seen, 
I  believe  these  measles  to  be  the  most  perfect  disease  of  their  genus,  for 
which  reason  I  shall  record  their  history  with  all  the  care  and  minuteness 
that  the  observations  which  I  then  made  will  warrant. 

2.  This  disease  begins  and  ends  within  the  above-named  period. 
It  generally  attacks  infants,  and,  with  them,  runs  through  the  whole 
family.  It  begins  with  shiverings  and  shakings,  and  with  an  inequality 
of  heat  and  cold,  which,  during  the  first  day,  mutually  succeed  each 
other.  By  the  second  day,  this  has  terminated  in  a  genuine  fever,  accom- 
panied with  general  disorder,  thirst,  want  of  appetite,  white  (but  not 
dry)  tongue,  slight  cough,  heaviness  of  the  head  and  eyes,  and  continued 
drowsiness.  Generally  there  is  a  weeping  from  the  eyes  and  nostrils;  and 
this  epiphora  passes  for  one  of  the  surest  signs  of  the  accession  of  the 
complaint.  But  to  this  may  be  added  another  sign  equally  sure;  viz. 
the  character  of  the  eruption.  Although  measles  usually  shows  itself  by 
an  exanthema  upon  the  face,  there  appears  upon  the  breast  a  second  sort 
of  breaking-out.  This  consists  in  broad  red  patches  on  a  level  with  the 
skin,  rather  than  true  exanthemata.  The  patient  sneezes  as  if  from  cold, 
his  eyelids  (a  little  before  the  eruption)  become  puffy;  sometimes  he 
vomits:  oftener  he  has  a  looseness;  the  stools  being  greenish.  This  last 


330  PEDIATRICS  OF  THE  PAST 

symptom  is  commonest  with  infants  teething,  who  also  are  more  cross 
than  •  usual.  The  symptoms  increase  until  the  fourth  day.  At  that  period 
(although  sometimes  a  day  later)  little  red  spots,  just  like  flea-bites,  begin 
to  come  out  on  the  forehead  and  the  rest  of  the  face.  These  increase  both 
in  size  and  number,  group  themselves  in  clusters,  and  mark  the  face  with 
largish  red  spots  of  different  figures.  These  red  spots  are  formed  by  small 
red  papulae,  thick  set,  and  just  raised  above  the  level  of  the  skin.  The 
fact  that  they  really  protrude,  can  scarcely  be  determined  by  the  eye. 
It  can,  however,  be  ascertained  by  feeling  the  surface  with  the  fingers. 
From  the  face — where  they  first  appear — these  spots  spread  downwards 
to  the  breast  and  belly;  afterwards  to  the  thighs  and  legs.  Upon  all  these 
parts,  however,  they  appear  as  red  marks  only.  There  is  no  sensible  pro- 
tuberance by  which  they  show  themselves  above  the  level  of  the  skin. 

3.  In  measles,  the  eruption  has  not  the  same  effect  in  allaying  the 
previous  symptoms  as  it  has  in  smallpox.  The  cough  and  fever  still  con- 
tinue, so  does  the  difficulty  of  breathing.  The  defluxion  and  the  weakness 
still  remain  in  the  eyes.  The  continued  drowsiness  and  want  of  appetite, 
all  keep  on  as  before.  The  continuance,  however,  of  the  vomiting  I  have 
never  yet  observed.  On  the  sixth  day — there  or  thereabouts — the  fore- 
head and  face  grow  rough,  the  cuticle  being  broken,  and  the  pustules 
dying  off.  At  the  same  time,  the  spots  upon  the  rest  of  the  body  attain 
their  greatest  breadth  and  redness.  By  the  eighth  day  the  spots  have  dis- 
appeared from  the  face,  and  show  but  faintly  elsewhere.  On  the  ninth 
day  there  are  no  spots  anywhere.  In  place  thereof,  the  face,  trunk,  and 
limbs  are  all  covered  with  particles  of  loosened  cuticle,  so  that  they  look 
as  if  they  have  been  powdered  over  with  flour,  since  the  particles  of 
broken  cuticle  are  slightly  raised,  scarcely  hold  together,  and,  as  the 
disease  goes  off,  peel  off  in  small  particles,  and  fall  from  the  whole  of  the 
body  in  the  form  of  scales. 

4.  The  measles  most  usually  disappear  about  the  eighth  day,  at 
which  time,  the  vulgar  (deceived  by  their  reckoning  in  cases  of  smallpox) 
insist  that  they  have  struck  in.  In  reality,  however,  they  have  finished 
their  course.  Thus  it  is  believed  that  those  symptoms  which  come  on  as 
the  measles  go  off",  are  occasioned  by  their  being  struck  in  too  soon;  for 
it  must  be  noted,  that  just  at  the  time  in  question,  the  fever  and  the 
difficulty  in  breathing  increase,  and  the  cough  becomes  so  harassing,  that 
the  patient  can  sleep  neither  night  nor  day.  Infants,  especially  when  they 
have  been  subjected  to  the  hot  regimen,  and  patients  generally  who  have 
had  recourse  to  hot  remedies  for  the  sake  of  promoting  the  eruption,  are 
liable  to  these  symptoms — symptoms  which  show  themselves  just  as  the 
measles  give  way.  Hence,  they  may  be  thrown  into  a  peripneumony,  and 
this  kills  more  patients  than  either  the  smallpox  itself,  or  any  symptom 
connected   therewith.   Yet,   provided   that  the  measles  are  properly 


THOMAS  SYDENHAM  331 

treated,  they  are  free  from  danger.  A  diarrhoea  is  a  frequent  symptom. 
This  may  succeed  the  disease,  and  run  on  for  weeks,  after  every  other 
symptom  has  departed;  and  it  is  of  great  danger  to  the  patient,  from  the 
loss  of  spirits  referable  to  the  profuseness  of  the  evacuation.  Sometimes, 
too,  after  the  more  intense  kinds  of  hot  regimen,  the  eruption  grows 
first  livid,  and  afterwards  black.  This  happens  in  adults  only;  and  when  it 
does  happen,  all  is  over  with  the  patient,  unless,  immediately  upon  the 
blackness,  he  be  assisted  by  means  of  bloodletting  and  the  cooling  effects 
of  a  more  temperate  method. 

5.  The  treatment  of  measles,  like  their  nature,  is  nearly  the  treatment 
of  smallpox.  Hot  medicines  and  the  hot  regimen  are  full  of  danger,  how- 
ever much  they  may  be  used  by  ignorant  old  women,  with  the  intention 
of  removing  the  disease  as  far  as  possible  from  the  heart.  This  method, 
above  others,  has  been  most  successful  with  me.  The  patient  is  kept  to 
his  bed  for  no  more  than  two  or  three  days  after  the  measles  have  come 
out.  In  this  way  the  blood  may  gently,  and  in  its  own  way,  breathe  out, 
through  the  pores  of  the  skin,  those  inflamed  particles  which  are  easily 
separable,  but  which  offend  it.  He  has,  therefore,  neither  more  blankets 
nor  more  fire  than  he  would  if  well.  All  meats  I  forbid;  but  I  allow  oat- 
meal-gruel,  and  barley-broth,  and  the  like;  sometimes  a  roasted  apple. 
'  His  drink  is  either  small  beer,  or  milk  boiled  with  three  parts  of  water. 
I  often  ease  the  cough,  which  is  constant  in  this  disease,  with  a  pectoral 
decoction,  taken  now  and  then,  or  with  Iinctus,  given  with  the  same 
view.  Above  everything  else,  I  take  care  to  give  diacodium  every  night 
throughout  the  disease. 

1^  Pectoral  decoction,  Ibss; 

Syrup  of  violets, 

Syrup  of  maidenhair,  aa  5  iss. 

Mix  and  make  into  an  apozem.  Take  three  or  four 
ounces  three  or  four  times  a  day. 

1$  Oil  of  sweet  almonds,  3  i  j 
Syrup  of  violets, 

Syrup  of  maidenhair,  aa5  j ; 

White  sugar-candy,  q.  s. 

Mix,  and  make  into  a  Iinctus.  To  be  taken  frequently;  especially 
when  the  cough  is  distressing. 

1$  Black-cherry-water,  5iij; 

Syrup  of  white  poppy,  5  j. 

Mix,  and  make  into  a  draught;  to  be  taken  every 'night. 

If  the  patient  be  an  infant,  the  dose  of  the  pectoral  and  anodyne 
must  be  lessened  according  to  his  age. 


332  PEDIATRICS  OF  THE  PAST 

6.  He  that  uses  this  remedy  rarely  dies;  nor,  with  the  exception  of 
the  necessary  and  inevitable  symptoms  of  the  disease,  is  he  afflicted 
with  any  superadded  disorders.  It  is  the  cough  which  is  the  most  dis- 
tressing. However,  it  is  not  dangerous,  unless  it  continue  after  the 
disease  is  gone.  And  even  then,  if  it  last  a  week  or  a  fortnight,  by  the  use 
of  fresh  air,  and  the  proper  pectoral  remedies,  it  is  got  rid  of  with  no 
great  difficulty.  Nay,  it  may  go  off  of  its  own  accord. 

7.  But  if,  however,  the  patient,  from  the  use  of  cordials,  or  from  a  hot 
regimen,  be  in  a  condition  which  is  by  no  means  unfrequent  after  the 
departure  of  the  measles;  i.  e.  if  his  life  be  endangered  from  the  violence 
of  a  fever,  from  difficulty  of  breathing,  or  from  any  other  symptom  of  a 
peripneumony,  I  take  blood  from  the  arm,  and  I  do  it  with  remarkable 
success.  The  bleeding  is  proportionate  to  the  age;  but  it  can  be  applied 
even  to  infants.  At  times  I  have  even  repeated  it.  Under  Divine  Provi- 
dence, I  have  saved  many  infants  in  this  way,  and  I  know  of  no  other. 
The  symptoms  themselves  occur  with  infants  at  the  recession  of  the 
eruption;  and  they  are  so  fatal,  that  they  do  more  to  fill  Charon's  boat 
than  the  smallpox  itself.  Further — the  diarrhoea,  which  has  been  stated 
to  follow  the  measles,  is  equally  cured  by  bloodletting.  It  arises  (as  in 
pleurisies,  peripneumonies,  and  other  inflammatory  diseases)  from  the 
vapours  of  inflamed  blood  rushing  upon  the  bowels,  and  so  forcing 
them  to  the  secretion.  Nothing  but  venesection  allays  this.  It  makes 
a  revulsion  of  the  sharp  humours,  and  reduces  the  blood  to  its  proper 
temperature. 

8.  Let  no  one  wonder  that  I  recommend  bleeding  with  tender  infants. 
As  far  as  I  have  observed,  it  is  as  safe  with  them  as  with  adults.  Indeed, 
so  necessary  is  it  in  some  cases,  that,  in  respect  to  these  particular  symp- 
toms, and  in  respect  to  some  others  as  well,  infants  cannot  be  cured 
without  it.  For  instance,  how  could  we  ease  the  convulsions  of  the 
teething-time  of  infants — which  take  place  about  the  ninth  or  tenth 
month,  and  are  accompanied  with  pain  and  swelling  of  the  gums,  com- 
pression and  irritation  of  the  nerves,  and  paroxysms  that  arise  there- 
from— without  venesection?  In  such  cases  it  is  better  by  far  than  all  the 
most  vaunted  specifics;  be  they  what  they  may.  Some  of  these,  indeed, 
add  to  heat,  and  do  mischief;  and,  however  much  they  may  have  the 
credit  of  arresting  the  disorder  by  means  of  some  occult  property, 
frequently  kill  the  little  sufferer.  At  present,  too,  I  say  nothing  about 
the  immense  relief  afforded  in  pertussis — or  the  whooping  cough — of 
infants  by  venesection.  Here  it  leaves  far  behind  it  all  pectoral  remedies 
whatsoever. 

9.  What  has  been  said  concerning  the  cure  of  those  symptoms  which 
occur  during  the  going-off  of  measles,  occasionally  applies  to  the  treat- 
ment of  them  at  their  height.  It  does  so  when  they  are  occasioned  by  an 


THOMAS  SYDENHAM  333 

adscititious  and  artificial  heat.  In  1670,  I  was  called  in  to  see  a  maid 
servant  of  the  Lady  Anne  Barrington's,  suffering  under  this  disease, 
together  with  a  fever  and  difficulty  of  breathing,  with  purple  spots 
discolouring  the  whole  of  her  body,  and  with  other  symptoms  of  the  most 
dangerous  kind.  I  put  down  all  this  to  the  hot  regimen,  and  the  abundant 
hot  medicines  which  she  had  used;  and  so  I  bled  her  at  the  arm,  and 
ordered  a  cooling  pectoral  ptisan  to  be  taken  frequently.  By  the  help 
of  this,  and  by  a  more  attempered  regimen,  the  purple  spots  and  the 
other  bad  symptoms  gradually  disappeared. 

10.  This  disease,  as  stated  above,  began  in  the  month  of  January, 
and  increased  every  day  until  the  vernal  equinox.  From  that  time  for- 
wards it  decreased,  and  wholly  disappeared  in  July.  With  the  exception 
of  a  few  places,  where  it  showed  itself  in  the  following  spring,  it  never 
returned  during  any  of  the  years  in  which  the  present  constitution 
prevailed.  So  much  for  the  measles. 


J.  s. 

[1664] 

THERE  is  another  interesting  little  book  on  children's  diseases 
by  J.  S.,  printed  in  1664. 1  have  searched  for  J.  S.,  who  appar- 
ently lived  at  Cundle,  in  Northampton,  and  who  compiled  a 
book  from  various  authors,  a  catalogue  of  which  is  given.  J.  S.  may 
have  been  Jane  Sharp,  a  mythical  midwife,  under  whose  name 
someone  in  1671  published  "The  Compleat  Midwife's  Com- 
panion.' '  This  book  contains  interesting  chapters  on  various 
diseases,  among  others,  the  "King's  Evil,"  Risings  in  the  Head," 
"Of  a  Rupture  and  Broken  Belly"  and  "Of  Numbness  and  Palsy." 
The  book  is  interesting  as  showing  some  of  the  phases  of  pediat- 
ric thought  in  the  time  of  King  Charles  11.  A  few  extracts  will 
serve  to  show  the  author's  style  and  some  of  the  quaint  conceits 
of  the  time,  some  almost  as  strange  as  those  of  our  present-day 
imaginings.  The  following  description  of  scrofula  is  a  sample: 

OF  THE  KINGS  EVILL 

The  Kings  Evill  is  a  hard  or  Schirrous  Tumour  contrary  to  nature, 
growing  for  the  most  about  the  Neck,  and  chiefly  of  Children.  The 
immediate  cause  is  sometimes  Flesh,  but  very  seldome:  Sometimes  the 
Glandules  turn  into  this  Tumour,  but  most  frequently  Phlegm,  or 
Melancholy  hardned.  Some  think  the  Cause  is  an  Alamentary  Juyce 
hardned;  because  they  are  not  changed  into  a  digested  matter,  nor  do 
putrefie,  and  continue  a  long  time.  The  Antecedent  causes  are  youngness 
of  Age,  cold  and  moist  temper,  softness  of  Flesh  and  Muscles,  and  short- 
ness of  the  Neck,  thereby  the  humours  fall  easily  from  the  head  in  the 
neck,  and  cleave  tenaciously. 

The  Presage  is,  This  Disease  is  troublesome  and  wearisome  to  the 
Patient  and  Physician;  for  whatsoever  way  you  deal  with  them,  they 
are  exasperated,  and  if  they  seem  to  be  cur'd  return  again.  It  is  very 
difficult  to  cure,  but  with  Iesse  difficulty  and  danger  in  Infants  and 
Children,  then  in  youth,  because  they  often  degenerate  into  Cancers 
and  dangerous  Ulcers.  The  Kings  Evill  that  is  little,  superficial  and 
gentle,  are  not  very  dangerous  &  are  more  easily  cur'd:  but  such  as 

334 


J.  S.  335 

are  great,  deep  and  malignant,  are  pernicious,  and  for  the  most  part 
incureable. 

The  Kings  Evill  though  it  is  most  exactly  cur'd,  yet  it  returns  again, 
which  is  not  from  the  motion  of  the  Moon,  as  some  have  thought, 
because  they  have  return'd  after  a  Month,  a  year,  or  two  years:  but  the 
cause  is,  i.  The  Viscosity  thickens,  and  a  contumaciousnesse  of  the 
matter,  which  is  not  perfectly  eradicated  and  extirpated  in  the  Cure, 
but  some  part  is  left,  which  vitiates  and  corrupts  the  temper  and  nourish- 
ment of  the  part.  2.  The  Coat  or  Membrane  which  is  tenaciously  infix'd, 
that  it  can  scarce  be  extirpated,  and  so  is  filPd  with  new  matter;  if  it 
be  extirpated,  yet  there  remains  some  roots  or  ligaments,  out  of  which 
the  Membrane  or  Coat  grows  again,  and  so  the  Tumour  or  Kings  Evill 
remains. 

The  Cure  is,  taking  away  the  antecedent  cause,  and  correcting 
the  Debility  of  the  Parts,  which  make  Phlegme;  all  of  which  is  done  by, 
i.  A  Convenient  Diet,  let  the  Air  be  hot  and  dry,  the  sleep  little,  exercise 
moderate,  avoid  much  rubbing  or  kembing  of  the  head,  and  bearing 
weight  on  the  Head;  avoid  all  perturbations  of  the  mind  (except  moderate 
anger)  and  Wine  that  is  strong  and  thick;  if  you  use  Wine,  do  it  moder- 
ately and  mixe  it  with  water.  Let  your  meat  be  attenuating  and  drying, 
as  Bread  well  bak'd,  and  with  Anniseeds  or  Coriander-seeds.  Let  your 
flesh  be  of  Wild-fowl,  and  rather  roasted  then  boyled;  avoid  Spices,  as 
filling  the  head  with  vapours,  and  all  thick,  grosse,  viscid,  and  cold  meats, 
as  Beef,  Cheese,  Milk,  Eggs  fried  or  hard  and  the  like.  Hence  it  is  that 
the  Children  of  poor  persons  are  more  troubled  with  this  Disease  then 
the  Children  of  rich  men,  because  they  eat  grosse  and  ill  Diet,  which 
makes  and  foments  the  humour. 

J.  S.  had  a  fondness  for  popular  ideas  and  while  evidently 
not  much  impressed  by  them,  still  has  recorded  many.  These 
popular  notions,  not  alone  of  the  ignorant,  would  make  a  very 
interesting  collection.  Any  one  who  has  practiced  for  a  few  years 
could  start  such  a  study  and  it  might  read  as  follows: 

If  the  Child  is  bewitcht,  a  Saphir  or  Carbuncle  hung  about  the  Child's 
Neck  is  conceived  good;  so  is  Hartshorn  hung  in  the  House,  and  many 
more  which  I  omit  as  superstitious  or  false. 

The  dangers  and  horrors  of  diphtheria,  which  science  has 
robbed  of  its  worst  features,  have  always  made  a  deep  impression 
on  both  the  lay  and  professional  mind.  Perhaps  only  those  who 
saw  diphtheria  in  the  pre-antitoxin  days  can  adequately  appre- 
ciate J.  S.'s  graphic  little  paragraph  on  its  prognosis: 


nAlAHN  N02HMATA' 

Children?  Diseases  , 

BOTH 

Outward  and  Inward, 

From  the  time  of  their  Birth 

to  Fourteen  Years  of  Ase. 
WITH 
Iheir  Natures,  Caufes,  Signs, 
Prefaces  and  Cures. 

JX  THRES   BOOKS; 

i.l     ^External  7 

2.  Wf}umverfar>Dtfeafes. 

3*  j      {inward    j 
o*  LSO, 

rht  Rtftlulims  fif  man]  Profitable 
guejlions  concerning  children , 
and  of  Nurfts,  And  cf  Kurfing 
Children.     */  t-<;" 


By  ?.£  Phyfician, 


London »  Printed  by  W.  Q.  ami  to  be  Sold  by 

J.Vlajfordtt\6  Zach.Wntkins ax  their  Shop 

in  the  Temple  near  the  Church.  S  66  4. 


Title  page  of  a  work  by  "J.  S. 


J.    S.  337 

Prog.  All  Ulcers  of  the  mouth  are  hard  to  cure,  because  the  Medica- 
ment cannot  conveniently  adhere,  but  those  that  are  black,  stinking 
profound  &  very  painfull  are  very  dangerous  and  is  a  most  miserable  & 
horrid  death,  of  them  which  dye  and  are  consumed  by  this  Disease. 

The  treatment  of  hiccup  would  make  another  subject  worthy 
of  an  historical  paper.  From  the  earliest  times  it  has  made  a  pro- 
found impression  and  has  been  included  by  nearly  every  early 
writer  of  pediatrics.  (See  the  chapters  on  Hicket  in  Phaer,  Pemell, 
Heberden  and  others.)  Students  of  Plato's  "Symposium,"  and 
indeed  readers  of  Osier's  "Text  Book  on  Medicine,"  will  remember 
how  the  physician  Eryximachus  recommended  to  Aristophanes, 
who  had  hiccup  from  eating  too  much,  either  to  hold  his  breath, 
or  to  gargle  with  a  little  water;  but  if  it  still  continued,  "tickle 
your  nose  with  something  and  sneeze;  and  if  you  sneeze  once  or 
twice  the  most  violent  hiccough  is  sure  to  go."  This  quick  method 
of  treatment  has  come  down  to  us.  Says  J.  S.: 

It  is  related  by  some,  that  the  Herb  called  Alyssus,  held  in  the  hand, 
Iook'd  upon,  or  smell'd  to,  cures  the  Hiccough  by  Propriety  of  Substance. 
Others  say,  that  Sneezing,  and  holding  the  Breath,  cures  all  Hiccoughs: 
but  these  Helps  are  too  difficult  for  Children  and  Infants,  Sneezing  and 
Vomiting  because  they  evacuate  the  matter,  is  commended. 

In  the  following  account  of  fever,  doubtless  typhoid  or  some 
other  continued  fever  is  referred  to.  What  strikes  us  most  is  that 
baths  for  the  fever  are  recommended.  The  delusions  regarding 
the  shape  of  the  cupping  glass  in  relaxation  to  the  part  it  would 
draw  humours  from  are  instructive. 

OF  A  SYNOCHE  FEAVER 

Every  Synoche  [continued]  putrid  Feaver  in  Children  is  from 
obstruction  made  by  gross  humours  in  hot,  moist,  and  sanguine  bodies, 
and  the  putrid  matter  is  in  all  or  the  greater  veins. 

The  Cure  of  it  in  a  Child  between  7.  and  14.  years,  will  be  in  removing 
the  obstructions,  and  tempering  the  Febrish  heat,  which  will  be  done  by, 
1 .  A  convenient  Diet,  let  the  Air  be  cold,  motions  of  the  body  and  mind 
avoided;  if  the  belly  move  not,  use  a  Clyster  or  Suppository;  let  the 
Drink  be  water,  or  Barly  water;  the  Diet  sparing,  only  Barly  broth,  or 
Broth  of  Meat:  But  because  this  will  be  accounted  too  strict  and  hard, 
to  indulge,  you  may  add  to  the  Broth  bread,  and  sometimes  the  Yelk  of  an 
Egge,  but  be  careful  you  do  not  nourish  too  much,  because  the  strength 


338  PEDIATRICS  OF  THE  PAST 

and  the  Disease  are  nourished  together.  The  time  of  eating,  let  it  be  as  it 
was  when  the  Child  was  well. 

2.  Blood-letting;  Some  think  that  Blood-letting  ought  not  to  be 
before  the  Child  is  14.  years  old,  because  that  which  the  opening  of  a 
Vein  ought  to  do,  nature  doth  of  its  own  accord,  which  consumes  daily 
much  of  the  Childs  substance  by  insensible  transpiration,  therefore  it 
needs  not  evacuation,  lest  the  strength  be  dejected.  Others  are  for  Blood- 
letting, because  if  a  Child  can  endure  a  disease  from  fulnesse,  why  not  the 
remedy?  which  is,  Blood-letting;  otherwise  as  often  as  a  Disease  begins 
with  the  imbecility  of  strength,  especially  which  happens  out  of  a  natural 
dissipation  and  resolution,  so  often  will  that  Disease  be  certain,  and 
necessarily  mortal:  Besides,  they  which  are  against  Blood-letting  allow 
purges,  which  are  contrary  to  nature,  and  is  worse  then  Blood-letting: 
moreover,  they  bring  notable  examples  for  it,  as  Avenzoars  letting  of  his 
son's  blood  at  three  Months  old.  In  this  Feaver,  because  evacuating  blood 
is  an  excellent  remedy,  you  may  in  the  place  of  Blood-letting  use  Leeches 
which  with  ease  open  a  vein,  and  do  not  wast  the  Spirits,  they  will  be 
most  safely  applied  to  the  Thighs,  and  also  to  the  Arms:  Or  you  may  use 
Cupping-glasses,  which  are  not  to  be  used  in  the  upper  parts,  because 
they  draw  humours  from  the  whole  body  to  the  heart,  wherefore  it  is 
safer  to  apply  them  to  the  Loyns  or  Hips,  and  then  they  must  be  oblonge 
and  a  narrow  mouth,  because  to  draw  from  profound  parts;  If  you  apply 
them  to  the  Thighes,  they  are  to  have  a  broad  mouth,  which  draws 
from  the  parts  which  are  next  and  remote  according  to  Latitude. 

If  the  Belly  be  not  loose  use  a  Clyster  or  Suppository,  before  you  use 
Cupping-glasses  or  Leeches,  afterwards  endevour  to  remove  obstruc- 
tions by  internal  and  external  remedies,  that  attenuate  and  deterge  with- 
out any  notable  heat.  Take  Barly  half  a  Pugil,  the  Leaves  of  Hyssop  half 
an  handful,  boyl  it  according  to  Art;  Take  of  that  Decoction  two  Ounces 
and  an  half,  of  Simple  Oxymel  five  Drams,  mingle  it,  and  drink  it;  when 
you  have  thus  prepared  the  humours,  Purge  gently,  Take  of  Sebestens, 
two  Drams  of  Raisins,  the  Leaves  of  Hyssop,  the  Flowers  of  Borrage  of 
each  one  Pugill,  make  a  Decoction  according  to  Art,  take  thereof  three 
Ounces;  of  the  Hony  of  Roses  solutive,  and  of  Manna,  of  each  an  Ounce 
and  a  half,  mingle  them;  the  Purgative  Medicaments  may  be  lessened  or 
increased  as  the  body  requires. 

Outwardly  things  that  open  obstructions  are  convenient;  Such 
as  are  gentle,  as  meal  of  Barly  rubb'd  upon  the  Skin,  Barlywater,  and  a 
little  Oyl  of  Almonds,  cool  and  moisten  the  Breast,  and  prevent  the 
increase  of  the  heat  of  the  Breast.  A  Bath  of  fresh  Water  is  very 
convenient. 

This  way  may  be  observed  also  in  a  Tertian  or  Quartan  Feaver, 
respect  being  had  to  the  humour  that  is  faulty. 


J.  S.  339 

The  remarks  on  "A  Numbness  and  Palsy"  give  a  good  idea  of 
some  of  the  opinions  of  the  time,  with  some  inkling  of  the  locali- 
zation of  the  lesion  fom  the  paralysis  produced.  The  truth  of  the 
prognosis  holds  good  today.  The  chronic  paralysis  without  changes 
in  sensation  being  due  to  irreparable  lesions,  and  paralyses  with 
numbness  or  loss  of  sensibility  being  cases  of  neuritis,  they  tended 
to  spontaneous  cure  so  that  the  doctor  and  whatever  remedy 
happened  to  be  chosen  got  the  benefit. 

A  Numness  and  Palsy,  is  a  distemper  of  the  same  kind,  and  differ 
only  in  degree,  for  a  Numness  is  but  as  it  were  an  imperfect  Palsy,  and 
a  Palsy  is  as  it  were  a  certain  great  Numness. 

The  cause  is  a  pituitous  humour  which  by  coldness  &  moistness 
thickens  &  obstructs  the  Nerves,  that  they  cannot  receive  the  animal 
Spirits,  or  Influence  of  the  animal  faculty;  &  as  this  obstruction  and 
condensation  of  the  nerves  and  ways  of  the  faculties  is  more  or  Iesse, 
so  it  makes  numnesse  or  weker  motion  or  want  of  motion.  In  a  Palsy 
there  is  no  motion  because  the  wayes  of  the  faculties  are  totally  stopt, 
in  a  numnesse  they  are  not  stopt  completely,  therefore  the  faculty  oper- 
ates, and  there  is  a  weak  motion. 

The  external  causes  are  compressions  by  falls,  blowes,  binding 
tumours  or  other  causes  which  can  compresse  and  condensate  the  nerves 
that  a  free  ingresse  of  the  faculty  is  hindered. 

Signs,  if  a  part  is  affected  with  the  Palsy  it  cannot  move,  and  is  called 
the  Dead  Palsy;  if  with  numnesse,  the  party  can  move  but  weakly  and 
with  difficulty.  If  the  Disease  be  in  the  Spinalis  medulla  the  Arms  and 
all  the  inferiour  parts  are  hurt;  if  the  right  part  of  it  is  affected,  all  the 
parts  on  the  right  side,  if  the  left,  the  left  parts.  If  in  the  Osse  sacro  the 
parts  above  it  are  well  and  the  parts  inferiour  to  it  are  hurt. 

Prog,  every  Palsy  especially  that  which  is  inveterate  is  difficult  to 
cure  in  Children  but  numnesse  is  more  easie  to  cure. 

If  a  Feaver  or  trembling  comes  upon  a  Palsy  or  numnesse  it  is  very 
helpfull,  for  the  Feaver  dissolves  the  matter  of  the  Disease  and  the 
trembling  drives  the  same  matter  from  the  nerves. 

The  older  writers,  either  through  accident  or  design,  got 
something  picturesque  into  their  descriptions.  If  one  has  a 
liking  for  fine  phrases  and  an  ear  for  words,  great  pleasure  is  to 
be  derived  merely  from  the  joy  which  these  old  fellows  evidently 
got  from  their  own  writing.  Examples  are  numerous  and  the 
following  paragraph  on  worms  is  in  point. 

The  Signs  of  the  three  sorts  of  Worms  in  common  are  many,  a  Stink- 
ing  breath,    unquiet   sleep,  with   starting,    trembling,   grating   of  the 


340  PEDIATRICS  OF  THE  PAST 

Teeth,  Itching,  and  often  rubbing  of  the  Nose,  paleness  of  the  Face, 
red  by  Intervals,  the  Eyes  hollow  and  darkish,  the  white  whereof  being 
turned  pale  or  yellow,  spitting  much  Phlegme,  the  swelling  of  the  belly, 
with  murmuring  and  noise  in  it,  the  Griping  of  the  Belly  which  is  worse, 
when  one  is  fasting,  sometimes  looses,  Vomiting  and  Epilepsy. 

The  Signs  of  the  particular  Worms;  if  they  be  long,  then  the  biting 
of  the  Belly  is  more  vehement,  a  little  drye  Cough,  Hiccough,  a  vain 
desire  of  Vomiting,  abominating  meat,  sounding,  troublesome  dreams, 
with  trembling,  rising  up,  and  crying  out. 


JOHN  MAYOW 

[1643-1679] 

A    NEGLECTED    GENIUS 

THIS  neglected  child  of  genius  who  died  at  the  age  of  thirty-six 
and  who  at  twenty  had  given  evidence  of  his  great  powers  of 
observation  and  deduction  was,  according  to  Wood,  "de- 
scended from  a  genteel  family  of  his  name  living  at  Bree  in  Corn- 
wall." His  father  was  William,  and  his  mother  Elizabeth,  Mayow 
and  he  was  born  in  the  parish  of  St.  Dunstan  in  the  West  in  Fleet 
Street,  London,  in  May,  1643.  At  the  age  of  sixteen  he  was  received 
as  a  commoner  at  Wadham  College,  Oxford,  and  admitted  scholar, 
September  23,  1659.  On  the  recommendation  of  Henry  Coventry, 
Esquire,  one  of  the  secretaries  of  state,  he  was  elected  to  a  fellow- 
ship in  AH  Souls'  College.  He  was  graduated  bachelor  of  civil  law 
on  May  30,  1665,  and  d.  c.  l.  in  1670.  He  was  given  the  privilege 
of  studying  physic,  which,  as  Harvey  says,  exempted  him  from 
taking  holy  orders.  He  went  to  London,  where  he  did  not  join 
the  College  of  Physicians;  he  practiced  at  Bath,  especially  in  the 
summer  time,  where  he  enjoyed  a  great  reputation,  but  as  Wood 
quaintly  states,  "better  known  by  these  books  which  shew  the 
pregnancy  of  his  parts."  He  wrote  a  treatise  on  the  nature  of  the 
salts  in  the  waters  of  Bath,  published  as  a  chapter  of  his  tract,  "De 
Sal-Nitro,"  for  which  he  was  made  a  fellow  of  the  Royal  Society 
in  1678.  He  died  in  September,  1679,  at  the  house  of  an  apothe- 
cary bearing  the  sign  of  the  "Anchor,"  in  York  Street  near 
Covent  Garden,  and  he  was  buried  in  St.  Paul's,  Covent  Garden, 
Wood  says,  "having  been  married  a  little  before  not  entirely  to 
his  content." 

Mayow  is  not  mentioned  by  either  Evelyn  or  Pepys,  but  in 
Wood's  "Diary"  there  is  the  following  reference.  "Mr.  Mayow,  of 
AHsouIes  College  being  returned  from  a  journey  Mr.  Prestwick 
(a  notable  punner)  met  him  and  said  'Oh,  Mr.  Mayomet.' 
Asked  why  he  called  him  so,  'Because  Mr.  Mayow  is  well  met,'  of 
which  Wood's  comment  was  'verie  ridiculous.'" 

341 


342  PEDIATRICS  OF  THE  PAST 

Mayow  had  enemies:  Dr.  Thomas  Guidott,  denounced  his 
ideas  in  his  "Discourse  at  Bathe,"  1676,  saying  that  Mayow 
"ploughed  with  his  heifer."  A  charge  of  plagiarism  was  also 
brought  against  him  before  the  Royal  Society  by  Thomson,  but  it 
was  evidently  unfounded,  as  he  was  subsequently  elected  on  the 
proposition  of  Hooke. 

The  chemical  knowledge  of  the  time  was  curiously  crude. 
It  was  the  transition  period  from  alchemy  to  modern  chemistry  and 
the  former  had  fallen  into  disfavor  or  was  regarded  as  unworthy 
of  a  gentleman's  attention :  Shaw  in  a  preface  to  one  of  Robert 
Boyle's  works  points  out  that  it,  chemistry,  should  not  be  so 
considered  but  "one  of  the  principals  whereto  he  ought  to  addict 
himself  who  would  improve  either  philosophy  or  physic." 

The  medieval  idea,  that  fire,  air,  earth  and  water  were  all 
the  elements,  had  been  somewhat  enlarged  through  the  opinions 
and  the  suppositions  of  Basil  Valentine,1  of  Erfurt;  and  Paracel- 
sus taught  that  earth  was  composed  of  compounds  of  salt,  sulphur 
and  mercury.  Anything  that  could  be  burnt  contained  sulphur, 
as  sulphur  contained  the  spirit  of  combustion  which  became  visible 
in  flame  when  heated,  the  heat  causing  an  effervescence,  and,  the 
friction  so  engendered,  an  "incension"  occurred  which  set  loose 
the  spirit.  Gotch  has  given  a  delightfully  clear  description  of  the 
attitude  of  the  philosophers  of  the  time  in  regard  to  the  phenom- 
ena of  life.  The  first  striking  thing  was  that  everyone  had  to 
eat  and  drink.  The  food  by  means  of  the  salino-sulphurous 
compounds  formed  "humours"  and  these  were  good  or  bad  accord- 
ing to  the  diet  and  this  affected  the  character  and  disposition. 
The  drink  purged  or  washed  out  the  bad  "humours"  and  medicines 
were  given  with  reference  to  the  character  of  the  humours. 
As  Pemell  put  it:  "Wee  ought  to  give  to  Cholerick  persons  those 
things  which  purge  ChoIIer,  to  Flegmatic  bodies  those  things 
which  purge  Flegme,  etc."2 

The  fact  that  the  living  body  was  warm  and  the  dead  body 
cold  was  thought  to  be  due  to  fhe  heart  ceasing  to  beat,  inasmuch 
as  the  idea  was  that  the  heat  was  generated  in  the  heart  by  the 
"effervescence"  in  the  salino-sulphurous  particles  in  the  blood 

1  Identified  by  Sudhoff  with  Johann  Tholde,  the  editor  of  the  alleged  Valentinian 
writings. 

■  Vide  Pemell. 


John  Aiayow 
[1640- 1 679] 


JOHN  MAYOW  343 

and  an  "incension"  took  place  in  the  left  ventricle  from  which 
the  vital  flame  was  transmitted  to  the  whole  body. 

The  third  stumbling  block  was  the  respiration  which  was 
known  to  be  essential  to  life,  but  about  which  there  were  numerous 
fanciful  ideas.  Some  thought  that  it  cooled  the  blood,  others 
that  the  respiratory  movements  pumped  the  blood  through  the 
body,  whilst  the  wisest  thought  that  the  air  in  some  way  reached 
the  left  ventricle  where  it  aided  in  some  way  in  vital  processes,  and 
that  the  "effervescence"  of  the  blood  in  the  heart  produced 
vapors  or  steams  and  that  respiration  relieved  the  blood  of  "its 
excrementitious  steams." 

Into  this  whirl  of  ideas  Boyle  projected  the  idea  based  on 
experiments  on  animals  with  his  air  pump,  that  "there  must  be 
some  use  of  the  air  which  we  do  not  understand  that  makes  it  so 
necessary  for  the  life  of  animals." 

At  this  time,  at  Oxford,  there  was  a  brilliant  experimental 
physiologist,  Richard  Lower  (1631-1691),  on  whose  skill  in 
dissection  and  assiduity  much  of  the  reputation  of  the  famous 
Willis  rests.  Mayow  witnessed  some  of  his  experiments.  Lower 
had  transfused  animals,  had  noted  that  the  blood  of  suffocated 
animals  was  dark,  but  could  be  changed  to  bright  red  by  blowing 
air  through  the  lungs,  from  which  he  conceived  the  idea  that  the 
air  made  the  blood  fit  for  the  use  of  the  heart  and  other  organs. 

Mayow's  first  treatise,  "De  Respiratione,"  appeared  in  1668 
and  was  followed  the  next  year  by  his  "De  Rachitide,"  and  in 
1673  both  tracts  were  republished  at  Oxford  together  with  three 
other  tracts  with  the  following  title  page: 

Tractatus  quinque  medico-physici. 

Quorum  primis  agit  de 

sal-nitro  et  spiritu  nitro-aero. 

Secundus  de  respiratione. 

Tertius  de  respiratione  foetus 

in  utero  et  oro.  Quartus 

de  moto  musculari  et  spiritibus  animalibus. 

Ultimus  de  rachitide. 

Studio  Job.  Mayow,  LLD.  et  Medici 

Necnon  Coll.  omn.  anim.  in 

Univ.  Oxon.  Socii. 

Oxonii  E  Theati  Sheldoniano, 

An.  Dom.  MDCLXXIV. 


344  PEDIATRICS  OF  THE  PAST 

This  was  republished  at  the  Hague  in  1681  under  the  title  of 
"Opera  Omnia"  and  at  Geneva  in  1685.  Translations  were  made 
into  Dutch  (1684),  German  (1799)  and  French  (1840). 

This  "Tractatus  Quinque"  is  one  of  the  world's  greatest 
masterpieces  and  deserves  a  higher  place  than  that  usually 
accorded  it  by  historians.  Mayow  used  material  from  Boyle, 
Steno,  Malpighi,  Willis  and  Lower,  but  he  relied  chiefly  on  his  own 
observations  and  did  his  own  thinking.  He  doubtless  had  the 
clearest  head  of  all  his  contemporaries  and  saw  so  accurately 
that  Heidenhain  stated  that  Mayow's  description  of  the  mecha- 
nism of  respiration  is  almost  as  perfect  as  if  it  were  done  today. 
He  discovered  the  double  articulation  of  the  ribs  and  the  spine 
and  described  the  action  of  the  intercostal  muscles. 

The  "Tractatus  Quinque"  deals  with  nitre  (potassium  nitrate). 
Mayow  demonstrated  that  it  was  made  up  of  an  acid  and  an 
earthy  part  which  could  be  separated,  and  on  bringing  them 
together  again,  the  nitre  could  be  reformed.  He  demonstrated 
by  actual  experiment  that  a  living  animal  and  a  burning  flame 
have  the  same  effect  upon  the  air  and  that  both  flame  and  life 
were  extinguished  when  the  amount  of  air  was  limited,  as  under 
a  bell  glass.  One  of  his  most  beautiful  experiments  was  to  place  a 
readily  inflammable  substance  in  a  bell  jar  and,  after  altering 
the  air  by  a  burning  flame,  to  show  that  the  substance  could  not 
be  ignited  by  focussing  the  sun  on  it  by  means  of  a  lens.  He  also 
demonstrated  that  by  calcining  a  given  weight  of  antimony,  it 
gained  in  weight  instead  of  losing  it.  This  he  thought  to  be  due 
to  something  added  to  it  from  the  air  and  he  dealt  with  the  same 
change  in  rust,  fermentation  and  combustion.  This  substance, 
rediscovered  and  called  oxygen  by  Lavoisier  in  the  next  century, 
Mayow  discovered  and  called  the  igneo-aerial  particles,  but  later 
he  changed  this  to  nitro-aerial  spirit  or  vapor.  His  ideas  were  as 
clear  as  those  of  Laviosier,  though  his  terminology  differs.  Much 
of  the  so-called  new  in  medicine  is  merely  a  restatement  of  an  old 
idea  in  a  new  way.  Men  invent  more  new  names  than  new  ideas,  a 
fact  beautifully  phrased  by  Lowell  as  "science  peddling  with  the 
names  of  things."  Mayow  grasped  the  nature  of  what  we  now  call 
oxidation  processes.  The  rust,  the  souring  of  wine,  putrefaction, 
combustion  led  him  on  to  the  process  of  respiration.  He  explained 
that  the  changes  in  the  body  were  similar  to  combustion.  He  went 
further  and  extended  his  views  to  the  fetus  and  the  egg,  showing 


JOHN  MAYOW  345 

that  the  maternal  circulation  supplied  the  aerial  part  necessary 
to  life,  while  he  thought  the  egg  contained  air  enough.  Bostock 
says :  "  He  was  the  first  who  entertained  a  correct  opinion  respecting 
the  use  of  the  placenta  as  an  organ  supplementary  to  the  lungs." 
He  touched  on  a  great  variety  of  subjects,  gave  a  mechanical 
explanation  of  the  act  of  jumping;  the  action  of  saltpeter  in  the  soil 
with  relation  to  plants;  a  clear  idea  of  chemical  affinity;  that 
gunpowder  would  explode  in  a  vacuum  because  it  contains  the 
essential  nitro-aerial  particles  in  the  nitre. 

Mayow's  early  death  was  a  great  blow  to  science;  Hoefer  says 
it  delayed  the  advent  of  modern  chemistry  more  than  a  century. 
Mayow  is  remarkable  in  that  during  his  life  he  did  not  attain  the 
position  he  ought  to  have  had,  and  even  now,  but  few  have  heard 
of  him  or  his  work.  In  his  own  day,  little  or  no  attention  was 
paid  to  his  ideas.  Boyle,  Newton  and  others  write  as  if  they 
did  not  know  of  him  and  the  opinion  has  been  advanced  by  Gotch 
that  this  was  doubtless  due  to  garbled  accounts  of  his  work  by 
Hooke,  the  curator  of  the  Royal  Society,  in  the  official  publica- 
tions of  that  learned  body.  In  1798,  Dr.  Beddoes  called  him  "a 
neglected  genius/'  a  term  used  as  a  heading  by  Sir  Benjamin 
Ward  Richardson  in  his  article  on  Mayow  in  "Disciples  of  Aescu- 
lapius." Beddoes*  book  was  printed  at  Oxford  in  1790  and  is 
entitled  "Chemical  Experiments  and  Opinions  Extracted  from  a 
Work  Published  in  the  Last  Century."  A  few  years  later,  in  1798, 
Yeats  published  a  more  critical  review  called  "Observations  on  the 
Claims  of  the  Moderns  to  Some  Discoveries  in  Chemistry  and 
Physiology."  In  spite  of  the  fact  that  translations  were  made  into 
several  languages,  Mayow's  ideas  did  not  gain  ground,  possibly 
because  Stahl  had  hypnotized  the  scientific  world  of  the  eight- 
eenth century.  More  recently  Gotch,  the  Waynflete  Professor  of 
Physiology  at  Oxford,  paid  Mayow  a  graceful  tribute  in  a  delight- 
ful address  entitled  "Two  Oxford  Physiologists."  Mayow  figures 
sparingly  in  some  of  the  medical  histories  and  is,  of  course,  in 
Wood's  "Athenae  Oxoniensis."  P.  J.  Hartog  has  a  sympathetic 
account  of  him  in  the  "Dictionary  of  National  Biography." 
There  is  an  article  by  Sir  Benjamin  Ward  Richardson3  and  Sir 
Michael  Foster  comments  on  him  in  his  "History  of  Physiology." 
His  little  book  on  rickets  is  in  the  Library  of  the  Surgeon-General, 
as  well  as  some  of  his  other  works;  but  that  treasure  house,  the 

'Richardson,  B.  W.  Asclepiad,  Lond.,  1894,  xxxvn,  175. 


346  PEDIATRICS  OF  THE  PAST 

Boston  Public  Library,  has  not  even  listed  his  name  and  the  same 
is  nearly  true  in  the  Boston  Medical  Library.  A  sad  commentary 
when  we  consider  that  Mayow  is  a  genius  of  the  highest  rank. 
A  few  examples  of  his  style  will  be  found  of  interest;  none  more 
so  than  his  account  of  rickets,  especially  the  part  dealing  with  the 
diagnosis.  Note  how  he  has  shorn  Glisson  of  all  the  padding  and 
presented  the  facts  naked  as  a  skeleton. 


OF  THE  SIGNS  OR  SYMPTOMS  OF  THE  DISEASE 

The  Diagnosis  or  knowledge  of  this  Disease,  (as  of  others,)  doth 
depend  upon  the  understanding  of  the  Symptoms,  which  are  these  that 
follow. 

i.  The  proportion  of  the  parts  is  irregular:  viz.  The  Head  bigger  than 
it  ought  to  be. 

2.  The  Face  over-fat. 

TRACTATVS  SECVNDVS, 
DE 

RACHITIDE 


J  o  h:  Mayov,  Oxon.CoUt 
Omni  An:  Stag. 

Title  page  of  John  Mayow's  book  on  rickets. 

3.  The  Wit  too  acute  in  respect  of  the  Age. 

4.  The  external  Members,  chiefly  the  musculous,  lean  and  extenuated. 

5.  The  Skin  loose  and  slagging. 

6.  The  Bones  for  the  most  part  bowed,  and  those  about  the  Joynts 
standing  out,  and  knotty. 

7.  The  Spine  or  Back-bone  is  variously  inflected. 

8.  The  Breast  is  straight  or  narrow. 

9.  The  Extremities  of  the  Ribs  knotty. 

10.  The  Abdomen  somewhat  puffed  up,  and  stretched  out.  These 
things  are  outwardly  observed,  but  inwardly. 

11.  The    Liver    is    perceived    over-large;    as    also    most    of    the 
Parencbymaest  or  fleshy  substances. 


JOHN  MAYOW  347 

12.  The  Ventricle  and  Intestines  rise  into  a  greater  Bulk,  than  in 
those  who  are  sound. 

13.  The  Mesenterium  is  affected  with  Glandules  too  great;  if  not  with 
Strumae  or  Waddles. 

These  are  the  Symptoms  within  the  Abdomen;  with  the  breast, 

14.  The  Lungs  are  discerned  stuft  and  tumid;  and  the  same  some- 
times purulent,  strumous,  and  very  often  growing  fast  to  the  Pleura. 

15.  The  Jugular  Veins,  and  Carotid  Arteries,  are  sometimes  found 
larger  than  their  just  proportion;  but  the  Brain  is  faulty  only  as  to  its 
Proportion  and  massy  Bulk. 

16.  Lastly,  to  these  is  added  an  Enervation  of  almost  all  the  parts; 
also  a  certain  drowsiness  and  Impatience  of  Labour  and  Exercise:  For, 
the  little  Children  cannot  play,  except  sitting,  and  with  much  ado  can 
stand  on  their  feet.  And  at  last  in  the  Progress  of  the  Disease, the  burthen 
of  their  Head,  can  hardly  be  sustained  by  their  weak  neck. 

These  are  the  so  many  and  so  great  Symptoms  of  this  Malady:  In 
the  next  place  we  must  search  out  what  may  be  the  fruitful  cause  or 
mischief  of  so  numerous  an  off-spring. 

One  hears  little,  even  in  these  days  of  the  antagonism  of 
diseases,  and  but  few  examples  are  known  when  there  must  be 
many.  The  unfriendliness  of  the  staphylococcus  and  diphtheria 
bacillus  is  well  known,  erysipelas,  or  the  streptococci  and  the 
malignant  growths  have  received  some  attention,  the  effect  of 
vaccination  for  smallpox  on  whooping  cough  is  not  unfamiliar,  but 
how  many  readers  know  that  itch  coming  on  in  the  course  of 
rickets  "confers  much  to  the  cure  thereof."  We  have  it  on  good 
authority,  for  which  see  below,  and  at  the  same  time  be  thankful 
that  we  do  not  have  to  resort  to  it  as  a  cure. 

THE    PROGNOSTICK    OF    THIS    DISEASE    COMPREHENDED    IN 
SEAVEN  APHORISMS 

As  to  the  Prognosis,  Praescience,  or  Prognostication  of  the  Event  of 
this  Disease,  of  it  self  for  the  most  part  it  is  not  mortal :  yet  sometimes  the 
Symptoms  waxing  grievous,  it  degenerates  into  a  Phthisis,  Consumption, 
Etick-Feaver,  Dropsie  of  the  Lungs,  or  Ascites;  and  so  at  length  it  proves 
deadly  to  the  Patient.  But  a  more  easy  Prognostick  may  be  instituted 
from  the  Rules  following. 

1.  If  this  Disease  lay  hold  on  the  Patient  before  the  Birth,  or 
presently  after;  it  is  (then)  most  dangerous,  and  for  the  most  part  Lethal. 

2.  By  how  much  the  sooner  after  the  Birth  this  Affect  invades  (the 
Infant,)  it  is  so  much  the  more  dangerous. 


348  PEDIATRICS  OF  THE  PAST 

3.  By  how  much  more  the  Symptoms  of  the  Disease  grow  worse  and 
worse;  viz.  If  there  be  to  great  disproportion  of  the  Parts,  and  very  great 
extenuation;  so  much  the  more  difficult  is  the  Cure. 

4.  If  this  Affect  have  the  aforesaid  Diseases  joyned  with  it,  it  scarcely 
ever  terminates  in  Health. 

5.  Whosoever  are  not  cured  before  the  fifth  year  of  their  Age,  they 
are  sickly  all  their  life  time  afterwards. 

6.  The  Scab  or  Itch  coming  upon  this  Disease,  confers  much  to  the 
Cure  thereof. 

7.  We  need  not  doubt  of  their  Health,  in  whom  the  Symptoms  of  the 
Disease  are  not  increased,  but  rather  diminished. 

There  is  something  so  naive  about  some  of  the  early  remedies. 
They  are  always  sure;  that  they  might  not  succeed,  rarely  entered 
their  seventeenth  century  heads.  No  one,  of  course,  could  doubt 
the  efficacy  of  the  following : 

A  GENTLE  VOMITORY 

Take  of  the  wine,  or  Oxymel  of  Squils,  from  half  an  Ounce  to  an 
Ounce;  which  being  taken,  half  an  hour  after,  let  the  Patient  drink 
Posset-Ale  in  great  abundance;  then  with  a  Feather,  or  Finger,  thrust 
down  the  Throat,  provoke  Vomiting,  and  sometimes  repeat  it. 

Samples  of  prescriptions  of  the  horrendous  London  Pharma- 
copeia are  so  numerous  in  many  writers  of  the  period  that  one 
does  not  have  to  seek  far  to  find  all  sorts  of  queer  things  offered 
as  therapeutic  agents.  The  laity  of  today  sometimes  resort  to 
questionable,  and  often  horrible,  things  on  the  old  idea  that  as 
most  medicines  taste  badly,  so  most  things  which  taste  badly 
are  potent  medicines.  A  really  good  history  of  therapeutics  remains 
to  be  written  and  when  it  is  done  by  some  laborious  soul  it  will 
show,  more  than  anything  could,  how  the  mind  of  man  changes  not. 
Century  in,  century  out,  the  same  errors,  the  same  foolish  reme- 
dies, the  same  vain  hopes  of  a  panacea  and  the  end  is  yet  to  come. 
Medical  knowledge  is  like  the  gods  of  a  household  and  is  the 
possession  of  the  medical  profession;  the  better  physicians  keep 
the  valuable  heirlooms  from  antiquity  or  from  all  ages,  the  Lares 
and  Penates  of  the  household.  The  broken  and  outworn  things  of 
yesterday  are  discarded  in  favor  of  the  new  and  untried,  and  most 
of  these  in  turn,  go  into  the  waste-basket  and  the  garbage  can; 
only  the  best,  which  stand  the  test  of  time  and  experience,  are 


JOHN  MAYOW  349 

retained.  But  along  come  the  sects  and  the  laymen,  and  they 
rummage  in  the  refuse  and  carry  away  what  seems  to  them  good, 
the  worn  and  tattered,  cast-off  garments  that  Truth  tried  on  in 
other  days.  And  so  an  array  of  curious  remedies! 

We  smile  at  prepared  hog  lice,  and  turn,  gravely,  to  prepared 
bacteria,  most  of  which  will  be  in  the  ash-can  with  the  dawn  of 
the  morrow;  only  the  good  will  be  kept.  Hog  lice  keep  bobbing  up 
from  time  to  time.  Doubtless  they  will  come  round  again  with 
time,  and  when  they  do  let  the  prescriber  remember  how  John 
Mayow  used  them: 

A  POWDER 

Take  of  the  Powder  of  prepar'd  Hog-lice,  two  drams;  of  Nutmegs 
half  an  ounce;  of  the  flowers  of  salt  Armoniac,  two  scruples,  make  a 
Powder;  the  Dose  is  from  8  Gr.  to  15,  in  some  Apozeme,  Broth  or  any 
other  convenient  Liquor. 

Never  having  seen  Bier's  original  paper  we  cannot  say 
whether  he  gives  credit  for  his  idea  to  anyone  else.  Doubtless 
he  did  not  know  of  John  Mayow's  work.  Here,  however,  in  the 
middle  of  the  seventeenth  century  is  the  suggestion  and  Mayow 
speaks  of  it  casually  and  not  as  anything  new  on  his  part,  indeed 
it  is  also  in  Glisson's  "De  Rachitide." 

Moreover,  Ligatures  fitted  to  the  Thigh  and  Leg  upon  the  Knee,  and 
to  the  Arms  upon  the  Elbow  avail  much;  but  they  must  be  loose  enough 
and  soft,  so  as  they  may  not  hinder  the  increment  or  thriving  of  the 
Part  whereunto  they  are  applied:  For  the  Utility  of  Ligatures  consisteth 
in  this;  that  they  help  to  revel  the  afflux  of  Blood  from  the  Head,  & 
to  deduce  it  towards  the  extenuated  Parts.  To  this  Title  may  be  refer'd 
Fasciatio,  or  the  Swathing  of  certain  parts;  as  likewise  button' d  Boots, 
wch  help  much  not  only  to  strengthen  the  Parts,  but  further  to  correct 
the  Crookedness  of  the  Bones,  and  bending  of  the  Joynts.  But  in  the  use 
of  these,  care  must  be  taken,  that  they  press  down  a  little  the  protuber- 
ant part  of  the  Bone,  but  hardly  touch  the  hollow  part. 


WALTER  HARRIS 

[1647- 1 732] 

A  SEVENTEENTH-CENTURY  PEDIATRIST 

ONE  of  the  most  striking  figures  in  the  history  of  pediatrics  is 
Walter  Harris,  a  pupil  of  the  doughty  Sydenham,  the  master 
who  is  said  to  have  advised  him  to  study  Don  Quixote  as  a 
preparation  for  the  study  of  medicine;  a  jest  which  the  great 
master  is  also  said  to  have  made  to  Richard  Blackmore,  and  per- 
haps truly,  as  even  in  these  days,  we  known  how  a  prosperous  say- 
ing will  be  used  over  and  over  again.  We  may  suspect  the  worthy 
old  doctor  of  something  of  the  same  spirit  in  the  remark  he  made 
about  Harris'  book,  which  Harris  takes  great  pains  to  quote: 

I  might  add,  and  positively  affirm,  that  the  same  excellent  Author, 
after  he  had  vouchsafed  to  read  the  first  Edition  of  this  Book,  was 
pleased,  out  of  his  great  good  Nature,  to  speak  to  me  in  the  following 
words:  "I  never  flatter  any  Man,  nor  shall  I  flatter  you,  when  I  tell  you, 
that  I  never  before  saw  any  Book  that  I  had  Reason  to  envy.  For  in 
Truth,  I  think  your  little  Book  may  be  of  more  Service  to  the  Publick, 
than  all  my  own  writings."  I  do  not  mention  this  from  any  Principle  of 
Vanity,  Self-Love,  or  ill  Design,  but  as  it  were  from  the  Impulse  of 
some  hidden  Reason.  For  of  what  Use  is  Flattery,  or  vain  popular 
Applause  in  an  advanced  Age?  Or  what  can  an  undeserved  Commenda- 
tion signify  to  a  Man,  who  is  just  leaving  the  Vanities  of  this  World? 

Of  Harris's  life  we  know  but  little.  The  "Roll  of  the  Royal 
College  of  Physicians"  furnishes  nearly  all  the  biographical 
information  which  we  possess.  Short  accounts  are  also  given  in 
Haeser's  "History  of  Medicine, "  by  Norman  Moore  in  the 
"Dictionary  of  National  Biography,"  and  there  are  a  few  notes 
here  and  there  in  some  of  the  various  collections  of  medical 
biography,  such  as  those  by  Bayle  and  Thillaye  or  Jourdain. 

Harris  was  born  in  1647,  at  Gloucester,  England.  (Hirsch 
gives  the  date   as    1651,  but  this  is  doubtless  an  error.)  He 

350 


D  E 

MORBIS  ACUTIS 

3fnfcmttmu 


AUTORE 

Gualtero  Harris,  M.  D.  Celeberrimi 
Collegii  Medicorum  Ijtndincnftum 
Socio,  atque  Cenlbre. 


Hippocrates. 


L  0  H  D  I  N  I: 

Impenfis  Samuelis  Smithy  'ad  infignia 

Principis  in  Cxmeterio  Divi 

Pauli.     1689. 


Title  page  of  the  book  of  Walter  Harris. 


352 


PEDIATRICS  OF  THE  PAST 


sent  to  Winchester  School  and  from  there  to  New  College,  Oxford, 
where  he  received  his  degree  of  b.  a.  on  October  10,  1670.  He 
then  changed  his  creed  to  become  a  Roman  Catholic,  and  resign- 
ing his  fellowship,  journeyed  to  France,  where  he  studied  medi- 
cine, finally  taking  his  doctor's  degree  at  Bourges  on  July  20, 
1675.  ^n  tne  following  year  he  returned  to  London.  In  1678,  in 
consequence  of  the  Oates  plot,  all  Roman  Catholics  were  ordered 
to  leave  the  metropolis.  This  caused  Harris  to  recant.  He  left 
the  Church,  publishing  an  article  entitled  "A  Farewell  to  Popery." 
In  the  following  year,  1679,  ne  received  his  doctor's  degree  from 
Cambridge,  and  on  April  5,  1680,  became  a  candidate  of  the 
College  of  Physicians,  being  one  of  the  censors  in  1688,  1698, 
1700,  1704  and  1 7 14.  He  was  treasurer  from  17 14  to  1717  and 
consilius  from  171 1  until  the  time  of  his  death. 

In  1 58 1,  in  the  twenty-fourth  year  of  the  reign  of  Queen 
Elizabeth,  Richard  Caldwell,  m.  d.,  a  fellow  of  the  Royal  College 
of  Physicians,  and  Lord  Lumley  founded  a  surgical  lectureship 
and  endowed  it  with  fifty  pounds  a  year,  laid  as  a  rent  charge 
upon  the  lands  of  Dr.  Caldwell  and  Lord  Lumley.  The  early 
lecturers  were  appointed  for  life,  but  later  on  the  period  was 
changed  to  five  years,  and  since  1825,  the  lecturer  has  been 
nominated  annually,  but  generally  two  years  in  succession.  The 
Lumleian  lectureship  was  held  by  distinguished  physicians;  but 
strangely  enough,  most  of  their  names  are  not  familiar.  William 
Harvey  expounded  his  views  on  the  circulation,  as  Lumleian 
lecturer,  in  16 16.  Richard  Bright  held  the  position  in  1837.  It 
is  pleasing  to  note  that  Walter  Harris  was  appointed  in  1710 
and  held  the  position  until  his  death  on  August  1,  1732.  In  171 1, 
he  lectured  on  "De  Ossibus  Capitis";  in  1 714,  on  "Phlegmon";  in 
1 715,  "De  Ersipelate  et  de  Morbis  Cutaneis";  and  in  17 16, 
"De  Febribus." 

Another  honor  accorded  Harris  was  delivering  the  Harveian 
oration  on  several  occasions.  This  lectureship  was  founded  by 
Harvey  himself,  who  conveyed  his  patrimonial  estate  of  Burmarsh 
to  the  college.  This  was  left  to  promote  friendship;  once  a  month  a 
collation  was  provided  for  such  as  came,  "and  once  every  year  a 
general  feast  for  all  the  fellows:  and  on  the  day  when  such  feast 
shall  be  kept,  some  one  person  of  the  College  .  .  .  shall  make  an 
oration  in  Latin  publicly."  Harris  delivered  orations  in  1699, 
1707,  1 713,  and  1726:  that  of  1707  was  printed. 


WALTER  HARRIS  353 

As  a  physician,  Harris  was  a  pronounced  success  and  enjoyed 
a  large  and  fashionable  practice  in  the  gay  whirl  when  good  Prince 
Charlie  reigned  as  Charles  11.  Then  came  the  Revolution,  and  on 
the  recommendation  of  Archbishop  Tillotson,  he  was  made 
physician  to  King  William.  These  connections  brought  him  into 
greater  prominence  and  he  enjoyed  an  intimate  acquaintance  with 
royalty,  as  King  William  took  him  to  Holland  on  one  of  his 
campaigns,  and  their  discussions  on  the  absorbing  topic  of  garden- 
ing led  to  Harris*  publishing  a  description  of  the  King's  Palace 
and  Gardens  at  Loo. 

In  1694,  Queen  Mary  caught  smallpox,  which  developed  into 
the  hemorrhagic  variety,  and  she  died  on  the  eighth  day.  Harris 
sat  up  with  her  on  the  sixth  day  of  the  disease.  This  case  of 
smallpox  led  to  some  difference  of  opinion  and  involved  the 
famous  and  thoroughly  delightful  John  Radcliffe,  three  years 
younger  than  Harris,  and  at  the  time  physician  to  the  Princess 
Anne.  According  to  Bishop  Burnet,  Radcliffe  was  regarded  as 
negligent  and  unskilful,  and  he  was  blamed  for  the  Queen's  death. 
He  himself,  however,  thought  differently  and  stated  that  "her 
majesty  was  a  dead  woman,  for  it  was  impossible  to  do  any  good 
in  her  case,  when  remedies  had  been  given  that  were  so  contrary 
to  the  nature  of  the  distemper;  yet  he  would  endeavour  to  do  all 
that  lay  in  his  power  to  give  her  ease."  Harris  was  among  those 
present  at  the  necropsy.  One  cannot  pass  Radcliffe  by  without 
quoting  the  well-known  anecdote  of  that  sharp-tongued  physician : 
"In  1699,  King  William,  after  his  return  from  Holland,  sent  for 
Radcliffe,  and,  showing  him  his  swollen  ankles,  while  the  rest  of 
his  body  was  emaciated,  said:  'What  think  you  of  these?'  'Why 
truly,'  replied  Radcliffe,  'I  would  not  have  your  Majesty's  two 
legs  for  your  three  kingdoms.'" 

As  to  Queen  Mary's  case,  Harris  himself  attributes  her  death 
to  her  taking  the  advice  of  Dr.  Richard  Lower,  given  years  before. 
Lower  advised  the  Queen,  when  she  was  indisposed,  to  take  a  large 
quantity  of  Venice  treacle  on  going  to  bed,  and  so  promote  sweat- 
ing. About  two  years  before  her  fatal  smallpox,  she  told  Harris 
of  this  and  he  advised  against  the  practice,  warning  her  that 
"your  Majesty  will  some  time  or  other  undergo  an  extreme 
Hazard  of  your  life  from  a  Medicine  so  intensely  hot,  whensoever 
you  shall  be  seized  by  a  permanent  and  continued  Fever."  He 
goes  on  to  relate: 


354  PEDIATRICS  OF  THE  PAST 

However,  this  justly  admired  Queen,  forgetting  all  that  I  had  said, 
and  fixing  the  famous  Lower's  advice  firmly  in  her  Memory,  was  pleased, 
at  the  first  Attack  of  the  Small-pox,  to  take  Venice  Treacle  the  first 
Evening,  and  finding  no  Sweat  appear  as  usual,  she  took  the  next 
Morning  a  double  Quantity  of  it,  to  throw  out  a  Sweat  in  vain,  before 
she  asked  the  Advice  of  the  Physicians.  Thus  it  pleased  the  most  wise 
Governor  of  all  things,  suddenly  to  translate  the  best  of  Queens  from  her 
unworthy  People  into  Heaven.  Never  was  any  Mortal  bewailed  with  so 
many  Tears,  such  sincere  Lamentations,  and  such  universal  Sorrow,  not 
even  the  most  beloved  Parent  by  the  most  darling  Child.  For  not  only 
the  Loss  of  the  Queen  was  deplored,  but  the  Ruin  also  and  Destruction 
of  the  whole  Kingdom  was  at  that  Time  apprehended.  But  the  vehement 
Grief  which  the  Remembrance  of  so  great  a  Calamity  always  renews,  is 
much  lessened  to  me,  when  I  recollect  that  I  pointed  out  the  Rocks  on 
which  she  was  cast  away,  and  admonished  her  of  the  future  Danger. 

He  continues  with  an  account  of  her  Majesty's  fatal  illness, 
of  which  he  gives  a  graphic  description. 

Harris  was  the  author  of  a  number  of  works,  for  the  most  part 
containing  the  substance  of  his  lectures  at  the  College  of  Physi- 
cians. The  following  list  is  given  in  the  "Roll  of  the  Royal  College 
of  Physicians": 

Pharmacologia  Anti-Empirica;  or,  a  Rational  Discourse  of  Remedies, 
both  Chemical  and  Galenical.  8vo.  London,  1683. 

De  Morbis  Acutis  Infantum.  8vo.  Amsterdam,  1698. 

De  Morbis  Aliquot  Gravioribus  Observationes.  8vo.  London,  1720. 

De  Peste  Dissertatio,  Cui  Accessit  Descriptio  Inoculationis  Vario- 
Iarum.  London,  1721. 

Dissertationes  Medicae  et  Chirugicae.  8vo.  London,  1725. 

Following  the  account  of  the  diseases  of  children  in  the  English 
translation  are  some  seventy-nine  pages  entitled:  "Book  the 
Second.  Containing  Observations  on  Several  Grievous  Diseases." 
It  contains  observations  on  epilepsy,  palsy,  diabetes,  quinsy,  and 
the  like.  The  latter  part  is  given  over  to  various  phases  of  venereal 
disease.  He  appreciated  their  seriousness  and  their  devastating 
influence.  In  closing  his  little  book  on  several  grievous  diseases, 
Harris  sums  up  in  a  page  or  so  his  via  vitae  and  it  is  a  page  written 
by  a  sound  philosopher  or  at  any  rate  by  a  follower  of  sound 
philosophy,  whether  one  accept  the  Ciceronian  view  of  death  or 
not.  He  counsels  honesty,  freedom  from  avarice,  charity,  helpful- 


WALTER  HARRIS  355 

ness  and  courage.  In  a  sense,  his  philosophy  is  pragmatic  and  not 
unlike  that  of  Corin,  the  shepherd,  in  "As  You  Like  It." 

Moderate  Plenty  of  things  necessary  for  living  well  and  conveniently 
is  easily  supplied,  and  is  seldom  wanting  to  good  Men.  But  in  heaping 
up  Superfluities,  there  is  commonly  no  End  of  most  grievous  Cares,  no 
Weariness  of  the  greatest  Troubles,  no  Bound  of  Rapines;  as  if  that 
dreadful  Execration,  or  Fascination,  always  accompanied  the  Unjust 
and  Avaritious,  that  they  should  be  poor  in  the  Midst  of  Wealth,  and 
be  condemned  to  spend  a  very  unquiet  and  penurious  Life  in  the  Midst 
of  Abundance.  Our  short  Lives  slide  away  with  a  precipitate  Course. 
And  there  is  no  need  of  a  great  Pomp  of  Provision,  to  make  the  Journey 
agreeable,  nor  is  so  great  a  Plenty  necessary  to  be  laid  up  for  so  short  a 
Way.  I  think  it  well  done  by  them,  who  pass  their  lives  in  doing  well. 
Nor  should  wise  Men  lament  the  Death  of  the  Body,  which  is  followed 
by  the  Immortality  of  the  Soul.  For  then  at  last  it  is  manifest  that  we 
live,  when  we  are  departed  out  of  this  Life.  How  excellently  did  the 
Philosopher  speak  to  this  Purpose,  when  his  breast  was  swelling  with 
Hope,  full  of  Consolation,  and  his  Mind  greatly  aspiring  to  future  Joys, 
when  he  was  approaching  to  old  Age,  and  nobody  praising  it?  If  I  err 
in  this,  says  he,  that  I  believe  the  Souls  of  Men  to  be  immortal,  I  willingly 
err:  Nor  will  I  suffer  myself  to  be  persuaded  out  of  this  Error  as  long  as 
I  live. 


The  little  book  on  diseases  of  children  was  the  popular  treatise 
from  his  time  until  it  was  supplanted,  in  1784,  by  the  work  of 
Michael  Underwood.  The  first  edition  was  printed  at  Amsterdam, 
in  1698,  while  Harris  was  in  Holland  with  King  William.  It 
was  reprinted  in  1705,  1720,  1736,  1741  and  1745;  translated  into 
German  in  1691,  French,  1738,  and  twice  into  English,  1742 
(Norman  Moore).  The  English  translation  was  by  John  Mar- 
tyn,  f.  r.  s.,  professor  of  botany  at  Cambridge,  and  the  title- 
page  states  that  it  was  "written  originally  in  Latin  by  the  late 
Walter  Harris,  m.  d.,  Fellow  of  the  College  of  Physicians  at 
London  and  Professor  of  Chirurgery  at  the  same  College." 
Marty n  states  that  a  previous  translation  into  English  "was 
in  a  most  uncouth  style."  This  having  been  out  of  print,  the  1742 
translation  was  published  with  a  translation  of  the  author's 
observations  on  several  grievous  diseases.  Martyn  writes  that 
"he  wished  that  the  learned  author  had  used  rather  less  pro- 
lixity in  his  writings  and  been  more  sparing  in  his  'Digressions.' " 


356  PEDIATRICS  OF  THE  PAST 

He  wisely  omitted  "the  long  enumeration  of  the  Titles  of  the 
Illustrious  Parents  of  the  Doctor's  Infant  Patients." 

Harris  was  a  conceited  man,  of  that  there  can  be  no  doubt; 
and  had  Fate  been  kind  enough  to  spare  us  his  portrait,  there  is 
no  doubt  he  would  have  shown  it  in  his  face.  Still,  he  disclaims 
any  credit  for  his  work  in  his  preface,  where  the  modern  psycho- 
analyst would  shrewdly  discern  that,  in  attempting  to  keep 
away  from  a  subject,  he  overstepped  it  in  another  direction. 

For  let  a  Piece  be  ever  so  well  written,  yet  we  ought  by  no  Means 
to  suffer  ourselves  to  be  proud  of  it.  For  the  highest  Wisdom  and  Knowl- 
edge of  Men  seems  to  be  that  which  places  our  common  Folly  and  Ignor- 
ance before  our  Eyes.  And  the  more  any  one  exceeds  others  in  being 
conscious  to  himself  of  this  common  Ignorance  of  Things,  and  Deficiency 
of  right  Reason,  the  more  I  think  him  superior  to  others,  and  to  obtain 
the  first  Place  in  Knowledge. 

The  difficulties  and  discouragements  of  pediatric  practice 
made  a  deep  impression  on  Harris  and  he  is  at  pains  to  let  it 
be  known,  just  as  he  also  points  out  what  he  regards  as  an  infant, 
and  the  diagnostic  methods  to  be  pursued  in  dealing  with  such 
uncommunicative  creatures. 

I  know  very  well  in  how  unbeaten  and  almost  unknown  a  Path  I 
am  treading;  for  sick  Children,  and  especially  Infants,  give  no  other 
Light  into  the  Knowledge  of  their  Diseases,  than  what  we  are  able  to 
discover  from  their  uneasy  Cries,  and  the  uncertain  Tokens  of  their 
Crossness;  for  which  Reason,  several  Physicians  of  the  first  Rank  have 
openly  declared  to  me,  that  they  go  very  unwillingly  to  take  care  of  the 
Diseases  of  Children,  especially  such  as  are  newly  born,  as  if  they  were  to 
unravel  some  strange  Mystery,  or  cure  some  incurable  Disease. 

There  can  be  no  Doubt  but  that  a  perfect  Cure  of  the  Diseases  of 
Children  is  as  much  to  be  desired  by  all,  as  any  Thing  else  whatsoever 
in  the  whole  Art  of  Physick.  Nor  is  it  of  consequence  only  to  the  noble, 
the  powerful,  and  the  wealthy,  who  are  desirous  of  having  Heirs,  and 
preserving  them,  but  to  all  Parents  of  any  Rank  whatsoever;  for  Nature 
has  instilled  into  all  Men  an  almost  invincible  Love  and  Care  of  their 
own  Offspring.  Wherefore  I  shall  think  myself  happy,  if  I  can  strike  out 
a  few  Hints,  which  others  of  greater  Abilities  may  improve,  and  bring  to 
Perfection. 

By  an  Infant  I  mean  not  only  with  Galen,  one  of  a  Month,  two 
Months,  or  at  most  three  Months  old,  but  in  a  more  extended  Sense, 
as  it  is  commonly  understood,  a  little  Child  something  older,  as  far  as 


WALTER  HARRIS  357 

to  the  fourth  Year.  Under  the  Name  of  a  Child  I  comprehend  all  from 
that  Age  to  the  fourteenth  Year.  And  the  younger  the  Patient  is,  the 
more  easy  will  be  the  Cure  of  any  severe  Disease,  as  I  have  found  from 
the  best  Reasoning,  confirmed  by  manifold  Experience.  For  any  Impres- 
sion, either  good  or  ill,  is  sooner  made  on  the  moist  than  on  the  dry,  on 
the  soft  than  on  the  hard,  tho'  in  the  dry  and  hard,  when  it  is  once  made, 
it  continues  longer.  Infants  fall  into  Diseases  the  most  easily,  and  unless 
they  are  unskillfully  or  too  late  taken  care  of,  are  most  easily  restored 
to  Health. 

The  Diagnostick  of  the  Disorders  of  Children  is  not  to  be  formed  from 
their  own  Account,  or  from  the  Consideration  of  their  Pulse,  or  from  a 
curious  Examination  of  their  Urine,  so  much  as  from  the  Answers  of  their 
Nurses,  and  of  those  who  are  about  them.  For  the  Women  are  able  to  tell 
whether  they  are  sick  and  vomit,  and  how  long  they  have  done  so; 
whether  they  throw  up  Milk  or  Food  curdled;  whether  frequent  Cries, 
Watchings,  and  Uneasiness,  discover  them  to  be  griped;  whether  they 
have  sour  Eructations  or  Hickups;  whether  they  have  any  Cough; 
whether  their  Stools  are  larger,  smaller,  or  more  frequent  than  usual; 
what  Colour  they  are  of,  whether  white,  green,  or  of  the  full  yellow 
Colour  of  the  Bile.  They  can  tell  whether  they  have  little  Ulcers,  called 
the  Thrush,  spreading  in  their  Mouths  and  interrupting  their  feeding. 
If  you  ask  them,  they  can  answer  whether  they  have  Convulsions, 
greater  or  less,  of  a  longer  or  shorter  Continuance,  and  whether  they  have 
frequent  or  seldom  Returns;  they  can  see  whether  any  Part  of  the  Gums 
grows  white  or  swells,  and  therefore,  whether  it  is  their  being  about  their 
Teeth  that  disorders  them;  lastly,  whether  there  is  any  Thing  else  of 
Consequence,  whether  they  have  a  Swelling  of  the  Abdomen,  or  any 
other  Part,  whether  they  have  any  Eruptions  or  Pustules,  and  whether 
a  yellow  or  red  Colour  appears  externally.  As  for  most  other  Enquiries, 
they  seem  to  me  to  belong  rather  to  subtile  Speculation  than  Practice. 

Hereditary  influence  in  the  production  of  disease  in  children 
was  correctly  estimated  by  Harris,  who  states  that  "the  Knowl- 
edge of  the  procatarctic  Cause  must  not  be  totally  omitted." 
He  dwells  on  this  and  adds  an  interesting  little  paragraph  on 
eugenics: 

There  is  no  one  who  will  deny,  that  there  are  hereditary  Diseases, 
proceeding  either  from  one  or  other  of  the  Parents;  or  question  but  that 
the  Gout,  Epilepsy,  Stone,  Consumption,  etc.  sometimes  flow  from  the 
Parents  to  the  Children.  Whole  Families  proceeding  from  the  same 
Stock,  often  end  their  Lives  by  the  same  Kind  of  Disease.  For  the 
prolific  Seed  often  so  rivets  the  morbid  Disposition  into  the  Foetus,  that 
it  can  never  afterwards  be  removed  by  any  Art  or  Industry  whatsoever. 


358  PEDIATRICS  OF  THE  PAST 

But  let  those  who  prefer  a  strong,  vigorous,  and  healthy  Offspring  before 
Money,  take  care  to  avoid  epileptic,  scrophulous,  and  leprous  Mothers. 

With  the  passing  of  the  mint  julep  of  the  South,  the  only 
julep  which  the  mind  conjures  up  at  the  mention  of  the  word,  it 
is  not  uninteresting  to  read  a  paragraph  on  the  juleps  of  Harris* 
day  and  of  the  pearl  julep  and  others  later  on. 

The  modern  Juleps  by  the  Way,  derived  from  Distillation,  were 
wholly  unknown  to  the  ancient  Physicians.  Water,  Wine,  Ptisan,  or  a 
Decoction  of  decorticated  Barley;  Melicraton,  or  an  extemporaneous 
Mead;  <u*>o/xc\i,  or  Vinum  passulatum,  a  Sort  of  Raison  Wine,  being 
expressed  from  dried  Grapes;  Sapa,  or  boiled  Wine;  Posca,  Oxycratum, 
or  Vinegar  mixt  with  Water,  were  almost  all  the  Juleps  that  were 
used  by  our  Ancestors,  in  the  Practice  of  Physick.  But  whether  these 
Juleps  of  the  Ancients,  on  Account  of  their  Simplicity,  Smallness  of 
Expence,  and  evirop^a  or  those  in  modern  Practice,  because  they  are 
more  agreeable  to  the  Palates  of  the  Nice,  and  Desires  of  the  Rich, 
ought  to  be  preferred,  I  shall  leave  to  the  Determination  of  the  sagacious, 
skilful,  and  honest  Physician. 

Harris  knew  full  well  the  importance  of  correct  diet  in  early 
life  and  cautions  especially  against  errors  in  this  regard.  He 
condemned  the  use  of  flesh  in  infancy  and  stated  that  the  results 
of  this  regimen  are  "almost  inseparable  from  the  overfeeding  of 
tender  Infants."  Also, 

Crude  and  undigested  aliment  necessarily  produces  a  Putrefaction  of 
Humours:  from  which  Putrefaction  not  only  Worms  are  generated,  but 
various  and  grievous  symptoms,  by  which  the  poor  Wretches  are  wasted, 
very  often  depended  upon  it. 

In  these  dry  and  parlous  days  (July,  19 19),  Harris*  views  on 
wine  may  not  be  amiss.  Correctly  he  is  against  its  use  in  early 
life,  as  was  Galen  of  old,  and  there  are  those  who  agree  with  his 
decision  regarding  later  life. 

The  nearer  any  one  approaches  to  old  Age,  the  more  does  Wine 
moderately  taken  usually  agree  with  him.  For  the  languid  Heat  of  old 
Men  evidently  stands  in  need  of  spirituous  Helps,  which  are  plentifully 
supplied  by  Wine,  both  for  the  Preservation  and  Increase  of  their  natural 
Heat.  Wherefore  the  Nature  of  Infants,  being  the  most  remote  from  that 
of  old  Age,  is  greatly  injured  by  Wine,  for  their  Nerves  being  exceedingly 
weak  are  easily  destroyed  thereby,  and  their  tender  Bodies  are  gradually 
dissolved,  or  else  rush  hastily  into  feverish  Flames,  by  the  subtile  Heat 
of  Wine. 


WALTER  HARRIS  359 

How  delighted,  however,  would  the  Westerville  set  and  their 
followers  be  over  the  following  paragraph.  It  reminds  one  some- 
what of  the  descriptions  in  school  physiologies. 

Wine  of  all  Sorts  taken  too  freely,  as  well  as  all  Sorts  of  Spirituous 
Liquors,  destroys  the  natural  Ferment  of  all  Stomachs,  especially  those 
of  Children:  they  impair  the  Appetite,  burn  up  the  Coats  of  the  Stomach, 
and  wrinkle  them  like  Parchment  that  is  scorched  by  the  Fire;  but  they 
most  of  all  injure  the  nervous  Coat,  which  in  this  Case  is  of  the  greatest 
Moment,  and  by  Means  of  this  Coat,  weaken  all  the  Nerves  of  the  Body, 
and  most  certainly  drive  the  animal  Spirits  into  all  Sorts  of  Confusion. 
What  does  the  least  Injury  to  this  tender  Age  is  White  Wine,  which  was 
accounted  cold  by  the  Ancients,  but  is  not  absolutely  cold,  but  only 
comparatively  with  Regard  to  other  Wines,  whether  red,  tawney,  or 
yellow.  But  Galen,  as  was  said  before,  forbids  Children  to  taste  any 
Wine  at  all. 

In  another  place,  after  reviewing  the  modern  writings  on 
acidosis,  the  present  writer  was  tempted  to  paraphrase  Pilate's 
query:  "And  what  is  Acidosis?"  We  present-day  moderns,  as 
many  now  agree,  are  too  prone  to  the  vulgar  error  that  our  own 
opinions  are  new  and  original.  As  a  matter  of  fact,  for  the  most 
part,  they  are  neither.  Ideas  do  not  die.  They  fall  asleep,  per- 
haps for  centuries,  and  then  come  to  life  often  simultaneously  in 
several  different  places  as  scbwebende  Gedanken.  Witness  Gar- 
rison's account  of  the  caduceus  used  as  a  medical  symbol  by 
the  Babylonians  and  disappearing  to  bob  up  in  England  and 
Switzerland  in  the  sixteenth  century. 

To  read  the  moderns  is  to  believe  that  acidosis  and  alkalies, 
as  a  cure,  date  from  yesterday.  If  ever  anyone  lived  who  thor- 
oughly believed  in  the  noxiousness  of  acid  and  in  the  effectiveness 
of  testaceous  remedies  it  was  Harris.  Of  the  latter  we  shall  speak 
further  on.  Of  acidosis  he  says: 

All  the  Causes  of  the  Diseases  of  Infants,  which  have  been  already 
mentioned,  and  all  that  may  be  derived  from  them,  center  in  one  next 
and  immediate  prevailing  Cause,  namely,  an  Acid  prevailing  universally. 

He  describes  the  symptoms  as  follows : 

That  unequal  Condition  of  the  Chyle  of  Nutriment,  constantly 
owing  itself  to  a  predominating  Acidity,  chiefly  produces  a  Sickness, 
Vomiting,  and  sour  Eructations.  If  the  Affair  is  farther  prolonged,  they 
grow  paler  and  paler  by  Degrees,  and  the  discoloured  Countenance 


360  PEDIATRICS  OF  THE  PAST 

discovers  a  Mixture  of  yellow  or  green.  Then  the  Stomach  swells  with 
Inflations,  and  flatulent  Eruptions  are  thrown  upwards.  In  the  mean 
Time  a  red  Pimple  or  two,  a  sure  Sign  of  an  abounding  Acid,  appears  on 
the  Skin,  in  some  upper  Part  of  the  Body,  sometimes  on  each  Cheek, 
sometimes  on  the  Chin,  sometimes  on  the  Forehead,  or  Neck,  or  some- 
times lower  and  the  Infant  daily  grows  worse.  He  wheezes  also,  and  draws 
his  Breath  so  hard  as  to  disturb  the  Ears  of  those  who  stand  by  (acidosis 
and  asthma)  which  Symptom  is  always  found  to  affect  him,  especially 
if  he  is  fat,  whensoever  the  Disease  is  of  the  acute  Kind.  Besides,  he  is 
often  affected  with  a  light,  dry,  and  sometimes  suffocating  Cough; 
a  dry  one,  because  the  Acrimony  of  the  Humours  continually  vellicates 
the  Branches  of  the  aspera  arteria,  which  are  very  sensible;  a  suffocating 
one,  because  the  Bronchia  of  the  Lungs  are  grievously  loaded  with  serous 
Humours  distilling  upon  them,  and  not  finding  an  Outlet.  Moreover, 
because  they  have  the  greatest  Weakness  of  their  nervous  System,  and 
have  the  highest  Degree  of  Softness  and  Tenderness  in  their  Constitu- 
tion, therefore  they  are  ready  to  sink  under  the  violent  Agitation  of  the 
Breast,  being  in  a  Manner  suffocated,  and  black  in  the  Face.  But  if  the 
Coagulations  already  mentioned  descend  presently,  as  they  often  do, 
from  the  Stomach  into  the  Intestines,  they  sometimes  produce  Gripings, 
sometimes  greenish  Stools,  and  sometimes  violent  Loosenesses.  But 
whilst  the  Tragedy  is  acted  in  the  lower  Belly,  either  the  great  Pain  of 
the  Gripes  lights  up  an  acute  Fever,  which,  if  not  rightly  managed, 
usually  deprives  the  Infants  of  their  Lives;  or  else  the  Pain  being  a  little 
more  moderate,  and  giving  Way  perhaps  to  some  unskillful  Cure,  often 
ends  in  a  hard  Tumour  of  the  Abdomen,  (Tabes  mesenterica)  which  in 
some  readily  serves  to  promote  the  Rickets  or  King's  Evil. 

He  paints  a  gruesome  picture  of  marasmus,  convulsions  and 
death,  and  includes  in  the  list  of  troubles  owing  their  origin 
to  acid,  thrush,  ulcers  in  the  mouth,  green  stools,  the  watery 
gripes.1 

Harris  was  not  modest  about  his  hypothesis,  for  he  imme- 
diately starts  out  to  disclaim  any  honor,  a  sure  sign  that  he 
thought  it  his  due. 

Here  I  shall  note  by  the  by,  that  I  do  not  by  an  Means  seek  after  the 
Honour,  if  there  is  any  to  it,  of  finding  out  a  new  Hypothesis,  nor  if  I 
have  found  out,  or  in  any  Manner  established  an  Hypothesis,  do  I  think 
it  my  Business,  to  force  all  Sorts  of  Arguments,  even  in  spite  of  Nature, 
as  the  Custom  is,  to  strengthen  and  support  such  an  Hypothesis. 

1Cf.    Howland's  and  Marriott's  work  on  the  acidosis  accompanying  infantile 
diarrheas  and  their  suggestion  of  the  use  of  sodium  bicarbonate. 


WALTER  HARRIS  361 

He  also  foresaw  a  discussion  with  which  he  did  not  propose 
to  bother  himself. 

I  know  well  enough,  that  all  the  subtile  Animadverters,  will  find  fault 
with  this  Notion  that  I  have  started,  of  an  Acid  prevailing  in  all  the  more 
remarkable  Disorders  of  Children. 

He  goes  on  to  quote  at  length  from  Hippocrates  and  states: 

From  these,  and  many  other  Things  of  the  same  Sort,  which  are  laid 
down  at  large  in  the  above-mentioned  Book,  it  is  plain,  that  our  Divine 
Old  Man,  who  excels  all  others  in  Medical  Knowledge,  determined  as  a 
certainty,  that  those  secondary  Qualities,  namely,  Acidity,  Bitterness, 
Saltness,  and  such  Like,  being  joined  with  the  Symptoms  of  Heat  or 
Cold,  are  to  be  considered  chiefly  as  Principal  and  effecient  Causes  of 
Diseases.  And  therefore  I  shall  make  no  Doubt  to  add  that  it  necessarily 
follows,  that  the  Cure  itself  is  to  be  directed  in  the  first  Place,  not  so 
much  to  the  extinguishing  of  Heat  by  Cold,  as  to  the  blunting  of  an 
Acid,  the  Iatering  of  a  Bitter,  the  attempering  of  a  Salt,  the  cutting  of 
thick  Humours,  and  the  rendering  of  such  as  are  thin  and  too  fluid  more 
compact,  the  asswaging  such  as  are  rough,  and,  lastly,  to  the  opening 
of  the  obstructed  Ducts  of  the  Body,  and  freeing  them  from  their 
Infarctions. 

But  before  I  attempt  the  Cure  itself,  it  may  seem  proper,  according 
to  usual  Custom,  to  premise  some  Prognosticks. 

His  statement  about  the  seasonal  appearance  of  diarrhea  is 
equally  true  today;  we  have  done  little  to  make  any  change  in  it 
necessary. 

From  the  Middle  of  July  to  about  the  Middle  of  September,  the 
Epidemical  Gripes  of  Children  are  so  rife  every  Year,  that  more  of  them 
usually  die  in  one  Month,  than  in  three  or  four  at  any  other  Time: 
For  the  Heat  of  that  Season  commonly  weakens  them  at  least,  if  it  does 
not  entirely  exhaust  their  Strength. 

Harris  gives  Sylvius  de  Ie  Boe  credit  for  having  written 
about  acids  as  a  cause  of  disease  in  infants,  but  he  scorns  him 
for  his  use  of  narcotics  and  applies  to  him  the  name  of  the  "Opiate 
Doctor." 

As  to  the  cure,  Harris  wisely  insisted  on  simplicity,  which  we 
of  today  applaud;  yet  some  of  his  prescriptions  look  formidable 
enough.  On  this  point  he  says: 

As  their  Ailment  is  the  most  simple,  so  the  Medicines  that  are  com- 
monly to  be  given  them,  ought  to  be  simple,  but  little  receding  from  their 
natural  State,  and  for  the  most  Part  void  of  too  laborious  an  Artifice. 


362  PEDIATRICS  OF  THE  PAST 

Of  the  cure  another  quotation  may  be  used : 

But  if  we  may  be  allowed  fairly  to  speak  the  Truth,  and  so  not  desire 
to  lose  all  our  Pains  and  Trouble,  those  Things  which  tend  directly  to 
subdue  an  Acid,  are  the  only  Things  that  promote  the  Cure;  but  what- 
soever do  not  tend  that  Way,  at  least  disturb  the  tender  Bodies  of  Infants 
more  or  less. 

His  idea  was  first  to  neutralize  the  acid  and  get  rid  of  it  by 
purgation.  The  first  he  expounds  learnedly  and  at  length,  as 
the  preparation  of  the  acid;  finally,  after  paying  his  respects  to 
Hippocrates  and  Sydenham,  and  skilfully  belittling  the  efforts  of 
others,  he  comes  to  the  meat  of  his  therapeutics : 

The  Preparation  therefore  of  which  we  are  now  speaking,  is  not  by 
any  Means  to  be  obtained  by  Sudorificks  properly  so  called,  that  is,  by 
Medicines  that  heat  the  Body,  which  are  not  in  any  Degree  of  Advantage 
to  tender  Infants  or  Children,  but  are  found  many  Ways  to  hurt  them. 
Whereas  things  that  are  quite  temperate  will  securely  absorb  the  pre- 
vailing Acidity,  gradually  assuage  the  Ebullition,  and  become  powerful 
and  safe  Anodynes.  Such  are  Crab's  Eyes  and  Crab's  Claws,  Oister 
Shells,  Egg  Shells,  Chalk,  Coral,  Coraline,  Pearls,  Mother  of  Pearl, 
oriental  and  occidental  Bezoar,  burnt  Hart's-Horn,  burnt  Ivory,  Bone 
of  a  Stag's  Heart  (the  terra  sigillate  of  the  ancients),  shavings  of  Hart's- 
Horn,  Unicorn,  Armenian  Bole,  sealed  Earth,  Blood  Stone,  &c.  Of  Com- 
pounds, Gascoign's  Powder,  Goa  Stone,  and  Species  of  the  Confection 
of  Jacinth,  will  obtain  the  first  Place. 

On  the  choice  of  these  "testaceous  powders  or  absorbents  of 
acid,"  he  descants  at  some  length,  declaring  that  the  cheaper 
are  as  good  as  the  more  expensive,  albeit:  "For  such  Things  as 
cost  a  great  deal  of  Money,  and  are  brought  a  great  Way,  are 
always  the  best  in  the  Opinion  of  the  Ladies." 

Of  the  cheaper  varieties  he  has  certain  preferences : 

But  yet  if,  among  many  testaceous  Bodies  of  almost  the  same  Nature, 
I  would  prefer  one  before  the  rest,  I  should  commend  common  Oister- 
Shells,  such  as  are  found  on  the  Sea-Shoar,  and  have  endured  a  long 
Insolation,  being  ripened  into  Use  by  the  benign  Rays  and  viviftc  Heat 
of  the  Sun,  and  thereby  far  better  prepared  than  by  a  Chymical  Fire, 
and  changed  into  a  bluish  or  yellowish  Colour. 

Of  other  alkalies,  he  has  not  much  to  say,  but  dismisses  them 
with  the  following  statement : 

I  have  designedly  made  no  mention  of  Volatile  Salts,  whether  they 
be  oily  or  spirituous;  none  of  Mineral,  Lunar  or  Solar  Bezoar;  none  of 


WALTER  HARRIS  363 

Spirit  of  Sal  Ammoniac,  none  of  that  of  Hart's  Horn;  of  which  Spirits 
the  use  is  however  not  to  be  entirely  exploded  with  Regard  to  the  most 
tender:  because  they  excel  in  a  Power  of  Absorbing  Acids;  but  I  would 
observe,  that  they  are  to  be  used  with  the  greatest  Caution,  because  of 
the  no  small  Heat  that  accompanies  them.  And  therefore  we  have  to 
Reason  to  extol  Iixivial  Salts,  or  the  hotter  Cordial  Waters,  such  as 
compound  Peiony  Water,  Plague  Water,  Aqua  Coelestis,  Aqua  Mirabilis, 
strong  Cinnamon  Water,  and  such  like,  unless  they  are  given  in  a  very 
small  Quantity,  and  so  diluted  with  other  more  temperate  Waters,  so  as 
to  make  their  heating  Power  almost  insensible  to  the  Taste. 

After  going  over  his  ideas  on  the  subject  of  acid,  he  comes  to 
the  practical  part  designed  to  help  the  "young  beginner/'  Some 
idea  of  his  practice  may  be  had  from  the  following  suggestions : 

But  to  pursue  my  Design,  for  an  Infant  of  a  Year  old  in  a  Fever,  or, 
as  it  commonly  happens,  tormented  with  the  Gripes,  we  may  prescribe 
as  follows: 

Of  the  simple  compound  Powder  of  Crab's  Claws,  of  each  one  Dram, 
divide  them  into  six  equal  Parts. 

Or, 

Oriental  Bezoar,  Pearls  prepared,  and  Crab's  Eyes,  of  each  half  a 
Dram,  Species  for  the  Confection  of  Jacinth  one  Scruple,  reduce  them 
to  Powder,  and  divide  them  in  like  Manner. 

Oister  Shells,  prepared  without  Fire  three  Drams,  Native  Sulphur 
one  Dram,  Crystal  Mineral  two  Scruples,  reduce  them  to  Powder,  and 
divide  them  into  twelve  Papers. 

Or, 

Simple  Powder  of  Crab's  Claws  one  Dram,  Crab's  Eyes  prepared 
two  Scruples,  Cochineal  six  Grains,  reduce  them  to  a  very  fine  Powder, 
and  divide  them  into  six  Papers. 

The  Infant  may  take  one  of  these  Doses  immediately,  and  repeat  it, 
if  necessary,  two  Hours  afterwards,  and  then  once  in  four  Hours,  except 
when  asleep,  for  the  first  two  Days.  The  Powder  may  be  taken  in  a 
Spoonful  of  the  following  Julep,  drinking  another  Spoonful  after  it. 

His  suggestions  as  to  purges  for  infants  are  certainly  sound, 
for  after  mentioning  several,  both  simple  and  compound,  he 
sums  up  with  a  strong  vote  in  favor  of  rhubarb: 

Of  all  the  purging  Medicines,  I  know  none  more  suitable  to  the 
puerile  Age,  or  more  innocent  in  itself,  than  Rhubarb,  which  is  so  well 
known,  and  so  much  in  Use.  It  brings  down  the  Matter  of  the  Fevers  of 
Infants  both  gently  and  safely:  it  mildly  purges  the  Stomach,  nay  and 


364  PEDIATRICS  OF  THE  PAST 

the  whole  Body,  of  vicious  Humours,  and  strengthens  it  also;  and  there- 
fore is  the  fittest  to  be  given  to  Infants,  Children,  women  with  Child,  old 
Men,  and  such  as  are  already  weak  with  any  Disease.  Rhubarb  seems 
better  to  deserve  the  Name  of  Hiera  or  sacred,  than  Aloe,  which  was  so 
wonderfully  extolled  by  the  Ancients,  and  has  not  been  undeservedly 
celebrated  by  the  Moderns,  and  holds  the  first  Place,  and  is  the  Basis 
of  almost  all  Officinal  Pills.  Indeed,  on  Account  of  its  extraordinary 
Bitterness,  it  often  deserves  no  small  praise  in  grown  Persons;  but 
because  of  its  Acrimony,  corroding,  and  the  Heat  that  it  gives  the  body, 
it  is  not  very  safe  for  Children. 

The  last  score  of  pages  digress  somewhat  from  the  diseases 
of  children  to  a  sort  of  rambling  philosophy  on  the  nature  of 
things  in  general.  He  pays  his  respects  to  the  "Chymists"  and 
their  "Chymicals"  which  he  is  none  too  ready  to  use;  he  gets 
after  the  "bellows  blowers,"  "quacking  operators,"  and  "old 
women,"  and  gives  an  estimate  of  the  worth  of  the  wisdom  of  the 
ancients.  He  closes  his  treatise  in  a  pious  prayer,  which  shall  be 
our  last  quotation : 

May  the  great  and  good  God,  from  whom,  as  from  an  ever  inexhaust- 
ible Fountain,  all  good  and  happy  Things  continually  come  down,  and 
on  whose  Favour  and  Blessing  the  happy  Success  of  the  Art  of  Physick 
chiefly  depends,  vouchsafe,  out  of  his  immense  Goodness,  to  bless  what 
I  have  faithfully  written  with  a  sincere  Mind,  that  it  may  be  fore  the 
Publick  Benefit,  which  ought  always  to  be  preferred  before  private 
Advantage. 

Harris  was  not  a  great  physician,  not  a  master  mind,  not  an 
original  thinker,  but  he  wrote  a  good  book  that  held  its  place 
an  hundred  years;  he  was  a  shrewd  and  honest  practitioner;  a 
keen  observer,  particularly  of  the  action  of  drugs,  which  led  him 
to  teach  simplicity,  caution  and  common  sense.  As  will  be  seen 
from  the  portions  of  his  work  cited,  he  was  au  fond  one  of  the 
soundest  of  the  earlier  writers  on  pediatrics.  Was  he  bombastic? 
So  was  his  teacher  Sydenham,  and  the  age  in  which  he  lived  was 
tinctured  with  bombast.  Was  he  garrulous?  So  was  his  very 
human  contemporary  Pepys;  so,  too,  at  times,  were  Hippocrates 
and  Galen.  Was  he  conceited?  So  have  been  many  men  who  were 
successful  practitioners  but  not  very  profound  students  of  life. 
Taken  all  in  all,  he  was  a  delightful  old  fellow  and  one  with  whom 
any  present-day  pediatrist  might  spend  an  hour  with  pleasure 
and  with  profit. 


THE  FIRST  AMERICAN  PEDIATRIC  PUBLICATION 

[1677-8] 

THOMAS  THACHER 

[1620- 1 678] 

THE  earliest  pediatric  publication  in  America  is  the  well- 
known  "Brief  Rule  to  guide  the  Common  People  of  New 
England  how  to  Order  themselves  and  theirs  in  the  Small- 
Pox  and  Measles."  It  is  a  broadside  twelve  by  seventeen  inches  in 
size  and  was  written  by  Reverend  Thomas  Thacher,  who  was 
the  first  minister  of  the  "Old  South"  church.  It  was  printed  by 
John  Foster  of  Boston  and  bears  the  date  of  January  21,  1677-8. 
It  was  reprinted  in  1702. 

BRIEF  RULE 

To  guide  the  Common  People  of 

NEW-ENGLAND 

How  to  order  themselves  and  theirs  in  the 

Small- Pox  and  Measles 

The  Small  Pox  (whose  nature  and  cure  the  Measels  follow)  is  a  disease 
in  the  blood,  endeavouring  to  recover  a  new  form  and  state. 

2.  This  nature  attempts — 1.  By  Separation  of  the  impure  from  the 
pure,  thrusting  it  out  from  the  Veins  to  the  Flesh. — 2.  By  driving  out  the 
impure  from  the  Flesh  to  the  Skin. 

3.  The  first  Separation  is  done  in  the  first  four  Days  by  a  Feverish 
boiling  (Ebullition)  of  the  Blood,  laying  down  the  impurities  in  the 
Fleshy  parts  which  kindly  effected  the  Feverish  tumult  is  calmed. 

4.  The  second  Separation  from  the  Flesh  to  the  Skin,  or  Superficies 
is  done  through  the  rest  of  the  time  of  the  disease. 

5.  There  are  several  Errors  in  ordering  these  sick  ones  in  both  these 
Operations  of  Nature  which  prove  very  dangerous  and  commonly 
deadly  either  by  overmuch  hastening  Nature  beyond  its  own  pace,  or  in 
hindering  of  it  from  its  own  vigorous  operation. 

6.  The  Separation  by  Ebullition  in  the  Feaverish  heat  is  over 
heightened  by  too  much  Clothes,  too  hot  a  room,  hot  Cordials,  as 
Diascordium,  Gascons  powder  and  such  like,  for  hence  come  Phrenzies, 
dangerous  excessive  sweats,  or  the  flowing  of  the  Pocks  into  one  over- 
spreading sore,  vulgarly  called  the  FIox. 

365 


366  PEDIATRICS  OF  THE  PAST 

7.  The  same  separation  is  overmuch  hindred  by  preposterous  cooling 
that  Feaverish  boyling  heat,  by  blood  letting,  Glysters,  Vomits,  purges, 
or  cooling  medicines.  For  though  these  many  times  hasten  the  coming 
forth  of  the  Pox,  yet  they  take  away  that  supply  which  should  keep 
them  out  till  they  are  ripe,  wherefore  they  sink  in  again  to  the  deadly 
danger  of  the  sick. 

8.  If  a  Pbrensie  happen,  or  through  a  Pletborie  (that  is  fulness  of 
blood)  the  Circulation  of  the  blood  be  hindred,  and  thereupon  the  whole 
imafs  of  blood  choaked  up,  then  either  let  blood,  Or  see  that  their  diet, 
or  medicines  be  not  altogether  cooling,  but  let  them  in  no  wise  be  heating, 
therefore  let  him  lye  no  otherwise  covered  in  his  bed  then  he  was  wont  in 
health.  His  Chamber  not  made  hot  with  fire  if  the  weather  be 
temperate,  let  him  drink  small  Beer  only  warm'd  with  a  Tost,  let 
him  sup  up  thin  water-gruel,  or  water-pottage  made  only  of  Indian 
Flour  and  water,  instead  of  Oat-meal:  Let  him  eat  boild  App'es;  But  I 
would  not  advise  at  this  time  any  medicine  besides.  By  this  means  that 
excessive  Ebullition  (or  boyling  of  his  blood)  will  by  degrees  abate,  and 
the  Symptoms  cease;  If  not,  but  the  blood  be  so  inraged  that  it  will  admit 
no  delay,  then  either  let  blood  (if  Age  will  bear  it)  or  else  give  some  not- 
ably cooling  medicine,  or  refresh  him  with  more  free  Air. 

9.  But  if  the  boiling  of  the  blood  be  weak  and  dull  that  there  is  cause 
to  fear  it  is  not  able  to  work  a  Separation,  as  it's  wont  to  be  in  such  as 
have  been  let  blood,  or  are  fat,  or  Flegmatick,  or  brought  low  by  some 
other  sickness  or  labour  of  the  (Gonorrhea)  running  of  the  Reins,  or  some 
other  Evacuation:  In  such  Cases,  Cordials  must  drive  them  out,  or  they 
must  dry. 

10.  In  time  of  driving  out  the  Pocks  from  the  Flesb,  here  care  must  be 
had  that  the  Pustules  keep  out  in  a  right  measure  till  they  have  attain'd 
their  end  without  going  in  again,  for  that  is  deadly. 

11.  In  this  time  take  heed  when  the  Pustules  appear  whilst  not  yet  ripe, 
least  by  too  much  heat  there  arise  a  new  Ebullition  (or  Feaverish  boyling) 
for  this  troubles  the  driving  out,  or  brings  back  the  separated  parts  into 
the  blood,  or  the  Fleshy  parts  overheated  are  disabled  from  a  right 
suppuration,  or  lastly  the  temper  of  the  blood  and  tone  of  the  Flesh 
is  so  perverted  that  it  cannot  overcome  and  digest  the  matter  driven  out. 

12.  Yet  on  the  other  hand  the  breaking  out  must  not  be  hindred,  by 
exposing  the  sick  unto  the  cold.  The  degree  of  heat  must  be  such  as  is 
natural  agrees  with  the  temper  of  the  fleshy  parts:  That  which  exceeds  or 
falls  short  is  dangerous:  Therefore  the  season  of  the  year,  Age  of  the  sick, 
and  their  manner  of  life  here  require  a  discreet  and  different  Consider- 
ation, requiring  the  Counsel  of  an  expert  Physician. 

13.  But  if  by  any  error  a  new  Ebullition  ariseth,  the  same  art  must  be 
used  to  allay  it  as  is  before  exprest. 


&  Brief  Rule  to  guide  the 
CommonPeople  ofNevr- 
England  how  to  Order 
themfelves  and  theirs  in 
the  Small-Tox  and  Meafels* 

THE  Smallpox  (whofe  nature  and" 
cure  the  Meafels  follow  )  is  a 
difeafe  in  the  blood,  endeavour- 
ing to  recover  a  new  form  and 
ftate.  j»n 

a.  /uSlS  nature  attempts^  r.  By  Se- 
paration of  the  impure  From  the  pure, 
thrufting  it  out  from  the  Veins  to  the 
Fleih — 2,  By  driving  out  the  impure 
from  the  Flem  to  the  Skin. 

3.  THE  firft  Separation  ir  done  in  the 
firftfour  Days  by  aFeverilh  boilingfEbulli* 
tion  >  of  the  Blood,  laying  down  the  im- 
puriries  in  the  Flcftiy  parts  which  kindly 
cftc&ed  the  Feverifli  tumult  is  calmed. 

4.  THE  fecond  Separation  from  the 
Flefh  to  the  Skin,  or  Superficies  is  done 
through  the  reft  of  the  time  of  the  difeafe* 

5*.  THERE  are  leveral  Errors  in  order- 
ing thefc  fick  ones  xn  both  thefc  Opera- 

A  lion* 


The  first  American  contribution  to  pediatrics,  1677- 1678. 


368  PEDIATRICS  OF  THE  PAST 

14.  If  the  Pustles  go  in  and  a  flux  of  the  belly  follows  (for  else  there  is 
no  such  danger)  then  Cordials  are  to  be  used,  yet  moderate  and  not  too 
often  for  fear  of  new  Ebullition. 

15.  If  much  spitting  (Ptyalismus)  follow,  you  may  hope  all  will  go 
well,  therefore  by  no  means  hinder  it:  Only  with  warm  small  Beer  let 
their  mouths  be  washed. 

16.  When  the  Pustles  are  dryed  and  fallen,  purge  well,  especially  if 
it  be  in  Autumn. 

17.  As  soon  as  this  disease  therefore  appears  by  its  signs,  let  the  sick 
abstein  from  Flesh  and  Wine,  and  open  Air,  let  him  use  small  Beer 
warmed  with  a  Tost  for  his  ordinary  drink,  and  moderately  when  he 
desires  it.  For  food  use  water-gruel,  water-pottage ,  and  other  things  having 
no  manifest  hot  quality,  easy  of  digestion,  boild  Apples,  and  milk  some- 
times for  change,  but  the  coldness  taken  off.  Let  the  use  of  his  bed  be 
according  to  the  season  of  the  year,  and  the  multitude  of  the  Pocks,  or 
as  found  persons  are  wont:  In  summer  let  him  rise  according  to  custome, 
yet  so  as  to  be  defended  both  from  heat  and  cold  in  Excess,  the  disease 
will  be  the  sooner  over  and  less  troublesome,  for  being  kept  in  bed 
nourisheth  the  Feaverish  heat  and  makes  the  Pocks  break  out  with 
painful  inflammation. 

19.  In  a  colder  season,  and  breaking  forth  of  a  multitude  of  Pustules, 
forcing  the  sick  to  keep  his  bed,  let  him  be  covered  according  to  his  cus- 
tome in  health,  a  moderate  fire  in  the  winter  being  kindled  in  his 
Chamber,  morning  and  Evening,  neither  need  he  keep  his  Arms  always 
in  bed,  or  Iy  still  in  the  same  place,  for  fear  least  he  should  sweat  which  is 
very  dangerous  especially  to  youth. 

20.  Before  the  fourth  day  use  no  medicines  to  drive  out,  nor  be  too 
strict  with  the  sick;  for  by  how  much  the  more  gently  the  Pustules  do 
grow,  by  so  much  the  fuller  and  perfecter  will  the  Separation  be. 

2 1 .  On  the  fourth  day  a  gentle  Cordial  may  help  once  given. 

22.  From  that  time  a  small  draught  of  warm  milk  (not  hot)  a  little 
dy'd  with  Saffron  may  be  given  morning  and  evening  till  the  Pustules 
are  come  to  their  due  greatness  and  ripeness. 

23.  When  the  Pustules  begin  to  dry  and  crust,  least  the  rotten  vapours 
strike  inward,  which  sometimes  causeth  sudden  death;  Take  morning 
and  evening  some  temperate  Cordial  as  four  or  five  spoonfuls  of  Malaga 
Wine  tinged  with  a  little  Saffron. 

24.  When  the  Pustules  are  dryd  and  fallen  off,  purge  once  and  again, 
especially  in  the  Autumn  Pocks. 

25.  Beware  of  anointing  with  Oils,  Fatts,  Ointments,  and  such 
defensives,  for  keeping  the  corrupted  matter  in  the  Pustules  from  drying 
up;  by  the  moisture,  they  fret  deeper  into  the  Flesh,  and  so  make  the 
more  deep  Scarrs. 


THOMAS  THACHER  369 

26.  The  young  and  lively  men  that  are  brought  to  a  plentiful  sweat 
in  this  sickness  about  the  eighth  day  the  sweat  stops  of  itself,  by  no 
means  afterwards  to  be  drawn  out  again;  the  sick  thereupon  feels  most 
troublesome  disrest  and  anguish,  and  then  makes  abundance  of  water 
and  so  dyes. 

Few  young  men  and  strong  thus  handled  escape,  except  they  fall 
into  abundance  of  spitting  or  plentiful  bleeding  at  the  nose. 

27.  Signs  discovering  the  Assault  at  first  are  beating  pain  in  the  head, 
Forehead,  and  temples,  pain  in  the  back,  great  sleepiness,  glistring  of 
the  eyes,  shining  glimmerings  seem  before  them,  itching  of  them  also 
with  tears  flowing  of  themselves,  itching  of  the  Nose,  short  breath,  dry 
Cough,  oft  sneezing,  hoarseness,  heat,  redness,  and  sense  of  pricking 
over  the  whole  body,  terrors  in  the  sleep,  sorrow  and  restlessness,  beating 
of  the  heart,  Urine  sometimes  as  in  health,  sometime  filthy  from  great 
Ebullition,  and  all  this  or  many  of  these  with  a  Feaverish  distemper. 

28.  Signs  warning  of  the  probable  Event.  If  they  break  forth  easily, 
quickly,  and  soon  come  to  ripening,  if  the  Symptomes  be  gentle,  the 
Feaver  mild,  and  after  the  breaking  forth  it  abate;  If  the  voice  be  free, 
and  breathing  easie,  especially  if  the  Pox  be  red,  white,  distinct,  soft, 
few,  round,  sharp  top'd,  only  without  and  not  in  the  inward  parts; 
if  there  be  large  bleeding  at  the  nose.  These  signs  are  hopeful. 

29.  But  such  signs  are  doubtful,  when  they  difficultly  appear,  when 
they  sink  in  again,  when  they  are  black,  blewish,  green,  hard,  all  in  one, 
if  the  Feaver  abate  not  with  their  breaking  forth,  if  there  be  Swooning, 
difficulty  of  breathing,  great  thirst,  quinsey,  great  unquietness,  and  it 
is  very  dangerous,  if  there  be  ioyn'd  with  it  some  other  malignant 
Feaver,  called  by  some  the  pestilential  Pox,  the  Spotted  Feaver  is  oft 
joyned  with  it. 

30.  Deadly  Signs  if  the  Flux  of  the  Belly  happen,  when  they  are  broke 
forth,  if  the  Urine  be  bloody,  or  black,  or  the  Ordure  of  that  Colour;  Or 
if  pure  blood  be  cast  out  by  the  Belly  or  Gumms:  These  Signs  are  for  the 
most  part  deadly. 

These  things  have  I  written  Candid  Reader,  not  to  inform  the  Learned 
Physician  that  bath  much  more  cause  to  understand  what  pertains  to  this 
disease  than  I,  but  to  give  some  light  to  those  that  have  not  such  advantages, 
leaving  the  difficulty  of  this  disease  to  the  Physicians  Art,  wisdom,  and 
Faithfulness:  for  the  right  managing  of  them  in  the  whole  Course  of  the 
disease  tends  both  to  the  Patients  safety,  and  the  Physicians  disired  Success 
in  his  Administrations:  For  in  vain  is  the  Physicians  Art  imployed,  if 
they  are  not  under  a  Regular  Regiment.  /  am,  though  no  Physician,  yet  a 
well  wisher  to  the  sick:  And  therefore  intreating  the  Lord  to  turn  our  hearts, 
and  stay  his  hand,  I  am 

A  Friend,  Reader  to  thy  Welfare, 

Thomas  Thacher. 


WOLFGANG  HOEFER 

[1614-1681] 

THE  physician  who  first  described  cretinism  is  little  known: 
Hirsch  gives  him  ten  lines.  His  father  was  a  professor  of 
medicine  and  the  son  was  born  in  Freising  in  Upper  Bavaria. 
He  studied  medicine  in  Ingolstadt  where  he  settled  after  traveling 
in  Italy  and  France.  Like  many  physicians  of  his  time  he  moved 
about,  practicing  successively  in  Straubing,  Linz  and  in  Hungary 
at  Raab.  Finally  he  was  called  to  Vienna  as  an  imperial  counselor 
(K.  K.  Hojrath).  He  died  there  in  1681.  He  published  one  book, 
"Hercules  medicus,  sive  Iocorum  communium  medicorum  tomus 
unicus."  This  appeared  in  Vienna  in  1657,  was  reprinted  there 
in  1664  and  in  Nuremberg  in  1665  and  1675. 
The  translation  is  by  Dr.  Herbert  F.  Wright. 

FOOLISHNESS1 

Because  foolishness  (stultitia)  is  so  familiar  in  very  many  inhabitants 
of  the  Alps,  and  indeed  is  endemic,  some  ascribe  it  to  the  air,  others  to 
water,  still  others  to  Jood  and  education. 

But  beware  lest  you  decide  upon  the  first.  Otherwise  you  may  be 
exposed  to  the  same  reply  as  the  man,  who,  when  he  was  falsely  censuring 
the  foolishness  of  these  men  and  was  sharply  arraigning  the  defect  of  the 
air,  while  he  was  using  this  locality  in  a  liberal  manner  and  enjoying  the 
same  air  as  guest,  heard  the  following  reply:  "Depart  quickly,  good  sir, 
lest,  infected  by  the  same  air,  even  you  yourself  must  needs  be  foolish  in 
company  with  us." 

Not  the  second,  because  to  many  inhabitants  of  the  Alps  waters  are 
very  healthful  to  drink,  and  yet  very  many  of  them  are  foolish. 

Therefore  the  third  will  hold :  Jood  and  education.  And  this  opinion 
is  borne  out  by  other  considerations  in  my  frequent  examination  of  their 
diet  and  mode  of  life.  For  this  is  a  class  of  people,  who  delight  in  foods 
which  supply  much  excrement,  but  little  aliment;  they  are  displeased 
with  the  opposites;  on  this  account  they  are  voracious,  yet  never  full, 
except  to  the  point  of  bursting  when  the  abdomen  bends.  Their  children, 
in  this  manner  stuffed  at  least  four  times  a  day,  they  deposit  near  the 

1  The  italics  are  the  author's. 

370 


Title  Page  of  Wolfgang  Hofer's  "Hercules  Medicus" 


WOLFGANG  HOEFER  371 

oven,  and  instruct  them  neither  in  letters  nor  in  morals  nor  in  labors, 
frequently  they  pay  no  attention  to  their  [children's]  entreaties,  so  that, 
when  their  food  also  aids  their  melancholy  and  gloomy  spirits,  they  are 
necessarily  made  stupid  and  foolish. 

They  also  become  strumous  from  almost  the  same  cause.  For  while 
the  children  are  thus  neglected  and  leisurely  subside  into  themselves, 
"they  pile  upon  one  another  by  the  oven"  like  dogs,  devouring  choice 
bits  with  full  jaws;  they  distend  and  dilate  the  skin  and  the  little  glands 
around  the  neck;  and  because  their  heads  are  filled  with  gloomy  vapors 
by  similar  food,  the  latter,  being  turned  into  liquid  and  flowing  down, 
are  drunk  in  by  the  glands  or  form  new  glands  and  monstrous  strumas. 

Now  it  must  not  be  entirely  denied  that  such  hernias  of  the  throat, 
called  broncbocele  or  strumas  by  the  Alpine  inhabitants  themselves,  as 
if  an  endemic  disease,  can  be  contracted  by  a  common  potion  of  water 
tinged  with  mercury,  which,  by  a  singular  characteristic  which  it  possesses, 
causes  rheumatisms,  fatigues  the  jaws  and  teeth  and  joins  tumors,  as 
Reusner,  "Tractatus  de  scorbuto,"  rightly  gives  as  his  opinion.2  Now  the 
inhabitants  themselves,  when  questioned,  advise  travelers  to  abstain 
from  these  springs,  having  learned  from  experience  that  walking-sticks 
immersed  and  withdrawn  shortly  afterward  have  become  deformed  by 
very  many  knots  and  uneven.  But  because  such  springs  are  very  rare,  I 
have  decided  to  agree  to  the  opinion  adduced  and  demonstrated  above; 
with  this  one  addition,  that  through  such  a  mode  of  life  the  power  of 
reproduction  is  not  lost,  and  therefore  also  by  an  hereditary  evil  the 
parents  communicate  foolishness  to  their  offspring. 

1  said  above  that  these  Alpine  dwellers  are  displeased  by  better  and 
more  refined  food.  For  example,  take  at  least  the  sole  one,  which,  though 
most  distasteful  to  others,  they  nevertheless  consider  among  their  delica- 
cies and  call,  in  their  own  idiom,  muncken.  Oats,  just  as  they  are,  crushed 
with  a  millstone,  they  cook  in  a  baking-pan,  with  water,  sprinkled  with 
a  dash  of  salt,  until  it  takes  on  the  form  of  peeled  barley.  Then,  when  a 
large  enough  opening  has  been  made  in  the  middle,  they  pour  in  melted 
lard,  zerlassen  Schmalz,  and  dipping  a  spoon  therein  they  separate  a  part 
of  the  fast-clinging  porridge  and  devour  it. 

And  yet  they  use  such  foods  from  custom,  especially  the 
excrementitious  foods,  namely  those  the  greater  part  of  which  is  sepa- 
rated by  means  of  the  belly  and  the  smaller  goes  off  into  some  sort  of 
nourishment.  Even  if,  in  spite  of  custom,  they  approach  a  more  noble 
table,  if  they  feed  upon  foods  which  are  more  nourishing  and  less  excre- 
mentitious, they  pour  in  .  as  much  of  the  more  delicate  food  as  of  the 
accustomed  food.  Now  the  belly  and  the  second  and  third  parts  dedicated 
to  the  concoction,  out  of  the  better  food  which  has  been  supplied,  form 

2  See  also  Lang,  J.,  Epistulae  medicinales,  bk.  i,  epist.  43,  and  bk.  in,  epist.  4. 


372  PEDIATRICS  OF  THE  PAST 

more  of  an  alimentary  substance  than  of  an  excrementitious  one;  and  so 
suddenly,  not  without  complaint  as  regards  fitness  and  weight,  more  than 
is  just  is  assigned  to  nourishing  the  body  so  that  it  is  manifestly  afflicted 
and  falls  into  diseases.  I  could  produce  quite  a  few  cases  of  this  result,  but 
of  these  matters  enough  has  been  said. 

Note  that  Pliny  also3  calls  oats  "frumenti  vitium";  and  so  he  accuses 
the  people  of  Germany  of  being  barbarians  because  they  eat  porridge  of 
oats,  which  is  fodder  rather  for  beasts  of  burden. 

"Whether  the  use  of  reason  is  to  be  conceded  to  brute  animals  and 
what  kind,"  was  investigated  once  in  a  public  oration  of  an  Ingolstadt 
man.  Nor  should  any  one  wonder  that  such  a  question  was  considered, 
seeing  that  in  the  dog,  the  elephant,  the  parrot,  etc.,  we  see  effects  such 
as  are  commonly  seen  to  be  produced  among  men  by  reason.  So  that 
Hieronymus  Fabricius  ab  Aquapendente  in  a  singular  treatise  has 
attempted  to  show  that  among  brute  animals  there  exists  a  singular 
intelligence,  whereby  one  can  make  known  something  to  another.  But 
this  is  rightly  refuted  by  Horstius4  and  his  opinion  coincides  with  the 
conclusion  of  the  Ingolstadt  orator:  Namely  that  true  reason  belongs  to 
man  alone;  but  to  brutes  there  belongs  a  shadow  of  this  reason,  which 
Horstius  calls  the  effects  of  phantasy.5 

3  Bk.  ii,  ch.  xxv,  in  Rolfinc,  De  febribus,  folio  375. 

4  Opera,  tome  III,  decade  ii,  p.  24. 

*Cf.  Helmont.,  Title  "Venatio  Scientiarum,"  pp.   17-26. 


NILS  ROSEN  VON  ROSENSTEIN 
[  1 706-1 773] 

THIS  author  of  a  work  on  pediatrics  of  truly  great  worth  is 
almost  unknown  beyond  his  name.  The  biographical  details 
of  his  life  are  wanting  in  the  available  sources. 

A  professor  in  the  university  at  Upsala  and  later  at  Stock- 
holm, it  was  his  duty  to  lecture.  Some  of  the  lectures  were  on 
nurses  and  their  duties,  on  "costiveness,"  on  diarrhea,  pro- 
lapsus ani,  pneumatocele,  smallpox,  measles  and  on  inoculation 
in  both  diseases.  They  were  of  such  value  that  the  Royal  Academy 
of  Medicine  of  Sweden  ordered  them  published  in  its  "  Alma- 
nacks." There  was  such  a  demand  for  these  informing  bits  of 
medical  literature  that  many  were  soon  out  of  print  or  obtained 
with  great  difficulty.  In  order  to  meet  the  need,  the  Royal  Acad- 
emy collected  the  writings  and  they  were  issued  in  1771,  and 
doubtless  in  other  editions. 

Rosenstein's  book  comprises  some  364  octavo  pages,  divided 
into  twenty-eight  chapters,  in  the  English  translation  which  was 
done  by  Andrew  Sparrman,  m.  d.,  and  printed  in  London  in  1776. 
To  those  unfamiliar  with  smallpox  in  unvaccinated  children, 
Rosenstein's  account  may  be  recommended.  It  is  an  illuminating 
bit  of  clinical  description  well  worth  reading. 

His  description  of  diphtheria  is  not  so  well  done,  but  it  calls 
attention  to  the  voice  and  to  involvement  of  the  heart  with  the 
possibility  of  sudden  death. 

An  ingenious  method  of  getting  rid  of  round  worms  is  detailed. 
One,  of  course,  doubts  the  efficacy  of  such  a  treatment,  yet  the 
suggestion  is  worthy  of  note  as  something  a  little  different  in 
the  history  of  therapeutics.  Some  day  the  history  of  the  treat- 
ment of  disease  will  be  done  into  a  readable  romance.  The  field 
offers  opportunities  rarely  found  in  any  other. 

The  small-pox  is  very  difficult  to  know  in  the  beginning.  One  may 
assert  it  to  be  that  disease, 

1.  If  we  hear  that  the  small-pox  is  now  rife  in  the  neighbourhood. 

373 


374  PEDIATRICS  OF  THE  PAST 

2.  If  we  know  that  the  patient  has  not  had  it  before,  and  has  been 
lately  in  the  same  room  where  a  patient  lays  with  the  small-pox,  or  who 
lately  has  had  it;  or  if  he  comes  near  a  person  who  a  little  before  has 
visited  a  patient  affected  with  the  small-pox,  or  touches,  or  wears  such 
clothes  as  are  infected. 

3.  If  those  signs  appear,  which  generally  precede  exanthematic 
fevers;  such  as  weakness,  without  any  apparent  cause,  chilliness  and 
shivering,  with  a  succeeding  heat,  pain  in  the  loins,  heaviness  across  the 
breast,  and  an  inclination  to  groan. 

4.  We  are  still  more  convinced  that  the  patient  is  infected  with  the 
small-pox,  if  his  face  seems  to  be  puffed  up,  he  feels  a  heaviness  over  his 
eyes,  and  some  tears  flow,  especially  from  the  left  eye;  but  these  being 
now  less  hot  than  in  the  measles:  besides,  if  he  feels  a  pain  in  the  pit  of 
the  stomach,  when  it  is  pressed  with  the  hand,  has  likewise  a  dullness, 
and  great  propensity  to  sleep,  even  in  unusual  hours,  or  has  startings 
during  his  sleep,  and  a  great  inclination  to  vomit. 

The  fever  continues,  but  not  equally  violent,  till  the  breaking  out  of 
the  pustules;  a  little  before  that,  some  children  become  convulsive,  which 
is  commonly  a  good  sign,  or  signifies  a  benign  sort  of  small-pox,  provided 
the  child  is  not  besides  afflicted  with  a  difficult  dentition.  These  days 
constitute  what  is  by  physicians  called  the  first  stadium,  or  period,  and 
which  contains  something  more  than  72  hours,  or  takes  up  a  small  part 
of  the  fourth  day. 

About  the  fourth  day,  the  fever  begins  something  to  abate,  and 
immediately  after  the  eruption  follows.  It  appears  like  small  red  spots  or 
pimples,  resembling  pin-heads;  at  first  they  break  out  in  the  face,  on  the 
upper  lip,  on  the  sides  of  the  nose,  afterwards  on  the  other  parts  of 
the  face;  then  they  come  out  on  the  breast,  arms  and  hands,  and  last  on 
the  thighs,  legs  and  feet :  but  they  seldom  break  out  on  the  belly,  as  the 
skin  is  there  very  tough;  neither  under  the  feet,  as  the  soles  of  the  feet 
are  thick  on  those  who  have  walked  much,  and  especially  without  shoes. 
These  above-mentioned  eruptions  increase  by  degrees,  grow  more 
elevated  and  broader,  with  a  white  point  or  summit,  and  their  basis  red; 
the  spaces  between  the  pustules  turn  likewise  red.  The  whole  body  seems 
puffed  up,  the  face  begins  to  swell,  but  chiefly  the  eye-lids,  so  that  they 
with  difficulty  can  be  opened:  proportionably  as  the  pustules  increase 
and  grow  elevated,  the  fever  decreases,  as  does  also  the  vomiting;  both 
of  them  disappear  as  soon  as  the  eruption  is  compleated;  those  days  are 
by  physicians  called  the  second  stadium,  or  period,  and  is  of  forty-eight 
hours  or  two  days  duration. 

The  third  period  takes  its  beginning  when  all  the  pustules  of  the  face 
are  broke  out,  and  is  finished  or  at  an  end  when  they  begin  to  dry.  This 
period  commonly  continues  till  the  eighth  or  ninth  day,  during  which 


\J  P>     1 


//rs/.  &t//Sis#<x/.  c^yy 


mmmNsmmm&mm 


Nicol  Rosen  Von  Rosenstein 
[ i 706-1 773] 


NILS  ROSEN  VON  ROSENSTEIN  375 

time  the  pustules  begin  to  ripen  and  look  yellow;  that  is,  they  suppurate, 
or  are  filled  with  pits,  grow  elevated  and  broader,  their  bases  are  red  and 
painful;  the  skin  or  interstices  between  the  pustules  continue  reddish, 
the  swelling  in  the  face  increases,  so  that  the  eye-brows  cannot  be  opened; 
therefore  one  is  said  to  be  blind  till  the  swelling  subsides  again.  The  eyes 
can  then  be  opened  and  see  as  before,  which  happens  on  the  eleventh  day: 
when  the  swelling  of  the  face  abates,  it  goes  into  the  hands  and  fingers, 
and  at  last  into  the  feet.  In  this  stadium  or  period,  the  fever  returns  again, 
except  it  is  a  very  benign  sort  of  small-pox.  This  second  fever  is  called 
the  suppurative  fever. 

The  fourth  period  begins  on  the  eleventh  day,  or  from  the  time  that 
the  pustules  begin  to  be  incrusted  or  scab,  and  continues  till  the  scabs  are 
fallen  off.  The  pustules  are  now  drying,  scaling  and  falling  off  in  the  same 
order  as  they  broke  out;  during  this  time,  it  often  happens,  that  a  part 
of  the  variolous  matter  or  pus  has  not  transpired,  but  is  absorbed  into  the 
blood,  and  causes  another  fever,  which  physicians  commonly  call  Jebris 
secunda  variolar  urn,  tho',  strictly  speaking,  it  is  the  third  fever  of  the 
small-pox;  but  as  it  sometimes  begins,  when  the  former  one  scarce  has 
gone  off,  it  is  no  wonder  that  they  are  confounded.  The  disease  sometimes 
is  so  favourable,  that  neither  the  first  or  the  second  fever  is  observable. 
A  true  small-pox  never  is  finished  under  eight  days. 

This  is  the  run  of  the  disease  (decursus  morbi),  when  the  pocks  are 
benign  and  regular;  but  when  they  are  of  a  malignant  kind,  they  will 
break  out  within  72  hours,  and  not  by  degrees,  but  all  at  once,  and  in  a 
large  quantity;  in  fine,  they  likewise  come  out  in  the  nose,  and  make  a 
stoppage  there,  as  also  in  the  throat,  and  cause  a  great  difficulty  in  swal- 
lowing. The  eruption  of  the  pustules  is  not  performed  in  the  same  manner 
and  order,  as  above  was  mentioned  of  the  other  sort,  but  begins  as  well  in 
other  places  as  in  the  face;  they  are  of  a  small  size  in  the  face,  but  never- 
theless they  often  run  into  one  another,  partly  in  consequence  of  their 
great  number,  partly  by  their  being  situated  too  close  to  one  another  in 
several  places,  and  therefore  broken  out  in  heaps,  or  in  bunches.  They  do 
not  turn  yellow  or  ripen,  and  are  consequently  not  filled  with  pits;  there- 
fore they  cannot  grow  elevated  and  pointed,  but  are  flat  and  depressed  in 
the  middle :  if  we  open  the  one  or  the  other  of  them  on  the  twelfth  day, 
still  only  a  water  is  discharged;  besides  they  put  on  an  unusual  colour, 
as  green,  violet,  or  black.  The  skin  looks  on  the  eighth  or  ninth  day  like 
parchment;  the  small-pox  is  likewise  of  a  bad  kind,  if  it  is  complicated 
with  a  difficult  haemorrhage,  or  petechial  spots,  or  with  pleurisy.  The 
fever  which  otherwise  should  cease  when  the  eruption  is  performed, 
continues  here  still.  The  other  suppurative  fever  does  not  come  on  gradu- 
ally, but  all  on  a  sudden,  and  with  violence.  The  spitting  begins  already 
in  the  second  period.  The  saliva  becomes  more  and  more  tenacious,  at 
last  it  is  suppressed,  and  may  suffocate  the  patient. 


376  PEDIATRICS  OF  THE  PAST 

Young  people  go  through  this  disease  with  more  facility  than  old 
persons,  and  the  younger  they  are,  the  more  successful  generally  is  the 
cure.  Nevertheless  we  have  instances  of  children,  who  have  got  a 
malignant  sort  of  small-pox,  and  died,  tho'  they  still  were  not  weaned; 
but  the  fault  may  then  lay  in  the  nurse,  or  nursekeeper;  for  instance,  how 
should  the  child  be  preserved,  if  the  nurse  at  that  time  eats  much  meat, 
is  of  a  bad  temper,  or  is  in  love;  or  if  she  has  her  menses,  sits  in  a  place  to 
swaddle  the  child  exposed  to  the  draught  of  air,  or  swaddle  it  seldom, 
and  that  in  linen  not  warmed,  tho'  it  should  have  wet  itself;  or  if  she  lies 
down  on  the  floor,  and  takes  the  child  by  her,  &c.  If  this  besides  happens 
at  the  time  of  teething,  the  child  can  hardly  by  any  means  be  recovered; 
if  the  pocks  settle  in  its  mouth  and  throat,  or  on  the  lips,  it  is  thereby 
prevented  from  sucking.  The  most  favourable  age  for  a  patient  in 
the  small-pox,  is  from  the  fourth  year  to  the  fourteenth,  and  the  next 
favourable  one  from  the  16th  to  the  25th. 

I  have  myself  observed  fat  children  to  be  as  often  favoured  with  a 
mild  kind  as  lean  ones. 

If  the  pustules  being  licked,  have  a  salt  taste,  the  child  that  has  them, 
is  commonly  expected  to  die,  but  not  else.  It  is  likewise  said,  that  the 
disease  will  be  severe,  if  the  hands  and  feet  shiver  in  the  first  stadium, 
or  period,  on  their  being  touched :  if  those  who  have  fed  well,  lose  much 
blood  just  before  their  falling  in,  either  by  wounds  or  otherwise,  they  will 
commonly  have  a  favourable  small-pox. 

It  is  no  good  sign  if  a  looseness  comes  on,  just  at  the  time  of  eruption, 
and  continues  still  some  days  during  the  breaking  out  of  the  postules. 
If  the  pocks  itch  immediately  after  their  coming  out,  they  will  not  be 
mild.  When  the  pain  in  the  loins,  and  the  vomiting  is  gentle,  no  very 
offensive  smell  comes  from  the  mouth,  the  nose  not  obstructed,  and  the 
throat  clean,  the  small-pox  will  then  be  benign,  et  e  contra. 

Haemorrhages  of  the  lungs,  and  of  the  anus,  are  threatening  signs; 
but  the  blood  being  voided  along  with  the  urine,  not  one  patient  among  a 
thousand  will  recover.  In  the  small-pox,  attended  with  petechial  spots, 
three  sick  are  sometimes  carried  off  out  of  four.  A  confluent  small-pox 
kills  sometimes  every  fourth  or  fifth  of  those  thus  affected. 

We  fear  a  bad  event  if  the  pustules  in  the  face  are  flat,  and  have  a 
depression  in  the  middle,  together  with  a  black  spot,  and  if  their  basis 
either  be  dark  red  or  pale,  and  indolent  in  the  third  period;  not  round 
and  hard  to  the  touch,  but  soft,  as  also  to  the  appearance,  as  if  they  were 
wrinkled  or  empty.  Neither  can  we  hope  for  any  good  success,  if  the 
patient  frequently  makes  water,  and  but  very  little  at  a  time:  if  the  urine 
then  looks  pale,  delirium  and  convulsions  are  imminent,  unless  the 
patient  has  lately  been  blistered  with  a  plaister  of  cantharides. 

A  diarrhoea  in  the  three  first  periods  does  no  good,  but  is  often  of 
service  in  the  fourth  period;  but  if  that  which  is  carried  off  looks  purulent, 


NILS  ROSEN  VON  ROSENSTEIN  377 

or  is  mixed  with  blood,  or  is  black,  the  belly  being  distended  and  swelled 
with  some  pain,  then  a  gangrene  has  already  taken  place  in  the  bowels: 
it  is  bad  if  the  suppurative  fever  does  not  come  on  by  degrees,  but  all  at 
once,  and  with  a  hard  pulse,  pain  in  the  head  and  eyes,  which  are  red  for 
want  of  sleep  (agrypnia),  and  much  uneasiness:  if  we  then  observe  a  hard 
pulsation  in  the  arteries  on  the  neck,  a  delirium  will  follow;  but  death 
itself  is  generally  the  consequence,  when  the  pulse  at  the  wrist  of  the  hand 
is  low  at  the  time  the  above-mentioned  blood  vessels  are  beating  hard. 

If  not  only  the  whole  face,  but  the  eye-brows  and  the  lips  swell,  it  is  a 
bad  sign;  but  the  patient  will  very  soon  die,  if  the  tumour  or  swelling  of 
the  face  withdraws  hastily,  and  does  not  immediately  go  to  the  hands;  if 
the  spitting  ceases,  the  skin  which  is  between  the  pustules  and  their 
bases  turns  pale,  he  likewise  being  short  of  breath,  his  voice  altered, 
with  a  peculiar  hoarseness,  and  if  he  is  also  observed  to  be  forgetful. 

When  he  has  many  pustules  in  his  throat,  what  he  drinks  returns 
through  the  nose.  This  is  the  cause  of  children  being  so  much  against 
drinking  during  the  small-pox,  and  is  in  that  respect  chiefly  dangerous, 
as  they  cannot  take  the  medicines,  though  in  this  disease,  unless  we 
drink  plentifully,  death  ensues. 

A  severe  cold  coming  on  while  the  disease  is  still  in  its  third  period, 
will  easily  suppress  the  spitting  in  a  severe  small-pox;  many  are  saved 
by  getting  large  boils,  provided  they  are  observed  and  opened  in  time. 

ON   DIPHTHERIA 

When  children  are  affected  with  this  disease,  they  lose  their  usual 
chearfulness,  are  something  hot,  and  some  of  them  cough;  they  complain 
of  a  slight  obtuse  pain  in  the  wind-pipe  somewhat  below  its  orifice;  and 
opposite  the  same  place,  on  the  outside  of  the  throat,  there  is  a  little 
swelling  to  be  observed  in  some  patients,  which  akes  a  little  on  pressing 
it  with  the  finger:  the  face  begins  to  look  red,  and  is  puffed  up:  nothing 
extraordinary  is  to  be  seen  on  inspecting  the  jauces,  and  there  is  seldom 
any  difficulty  of  swallowing,  but  the  breath  is  laborious:  a  fever  comes  on, 
with  a  hard  and  very  quick  pulse;  the  thirst  becomes  pressing;  the  patient 
coughs  sometimes.  All  this  increases  hastily,  and  on  a  sudden  the  pulse 
lowers,  and  grows  very  rapid,  but  weak;  the  breathing  becomes  more 
difficult,  frequent,  and  shorter;  the  pain  disappears,  the  coughing  ceases, 
and  death  comes  on  unexpectedly.  Some  patients  are  obliged  to  keep  in 
bed;  others  again  are  better  at  times,  and  able  to  walk  about.  A  child, 
who  was  walking  and  playingin  a  room,  died  as  its  mother  was  going  to  take 
it  up  in  her  lap.  It  is  peculiar  in  this  disease  that  children  enjoy  their 
understanding  till  the  last  moment,  and  that  their  voice  is  particularly 
hoarse  and  sharp,  somewhat  resembling  that  of  a  young  cock:  indeed  it  is 
impossible  to  give  an  exact  description  of  that  voice;  but  a  person  who 


378  PEDIATRICS  OF  THE  PAST 

has  once  heard  it  will  always  know  it  again.  This  sound,  which  is  a  certain 
and  infallible  sign  of  the  disease,  is  only  to  be  observed  in  some  of  the 
patients,  when  they  cry,  cough,  or  call  out. 

It  is  easy  therefore,  to  distinguish  this  from  the  other  diseases  of 
children  which  are  accompanied  with  a  cough,  hoarseness,  or  catarrh. 
It  seems  likewise  to  be  different  from  another  sore  throat  which  once  was 
almost  forgotten,  but  now  not  long  ago  carried  off  a  great  many  children 
in  England,  France,  and  even  in  Sweden,  and  was  called  a  malignant  sore 
throat,  Mai  de  gorge  gangreneux,  (Cynancbe  pbaryngea  epidemica)  because 
there  was  a  swelling  plainly  to  be  observed  in  the  fauces,  which  turned 
white,  ulcerated,  and  terminated  in  a  gangrene,  unless  speedy  relief  was 
procured. 

ON   WORMS 

The  ascarides  are  often  expelled  by  eating  raw  carrots,  or  drinking 
birch- juice,  or  by  sucking  the  juice  of  the  young  bark  of  fir,  till  one  gets  a 
looseness:  also  by  tying  a  string  to  a  piece  of  fresh  pork,  introducing  it 
into  the  intestinum  rectum,  and  pulling  it  out  again  after  a  little  time;  for  a 
number  of  these  worms  will  then  always  follow.  This  must  be  done 
repeatedly,  changing  the  pork  at  each  time,  in  order  to  evacuate  them  all. 
One  may  likewise  eradicate  them  with  clysters  of  tepid  milk  and  a  little 
salt,  or  with  our  common  mineral  waters  and  salt;  likewise  with  a  clyster 
of  a  drachm  of  fine  sugar  and  an  equal  portion  of  rats-dung,  well  rubbed 
together,  and  mixed  with  tepid  milk  (not  boiled),  to  be  injected  five  or 
six  nights  running. 

The  following  clysters  will  likewise  prove  a  good  remedy:  Take  one 
pint  of  water  and  an  ounce  of  quicksilver,  boil  it  gently  in  a  covered 
earthen  pot,  and  add  a  little  honey  to  it.  This,  being  injected  repeatedly, 
will  certainly  deliver  the  patient  from  these  guests. 

But  the  most  efficacious  remedy  is  a  clyster  of  tobacco-smoke.1 


ON   HOOPING   COUGH 

The  hooping-cough,  like  the  small-pox,  measles,  and  the  venereal 
disease,  never  appeared  in  Europe  originally,  but  was  transported  thither 
from  other  parts  of  the  world  by  means  of  merchandise,  sea-men,  and 
animals:  it  was  a  new  disease  to  our  ancestors  in  Europe,  and  probably 
was  conveyed  to  them  either  from  Africa  or  the  East- Indies,  where  it  was 
rooted  before. 

Its  first  appearance  in  Sweden  cannot  be  determined  with  any  cer- 
tainty; but  in  France  it  began  in  the  year  14 14. 

1  See  "Medical  Observations,"  Vol.  n,  p.  307. 


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jut  £ennfni&  unt>  €ut 

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into   mit    2l'nmecfungen   erlatttert 

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'Profeflforn  &er  SRe&icin  auf  &er  2ifa&emic 

ou  ©Jtrinjen. 


©otl)a  unt>  ©ottingcn 

bn)  3o&a«n  Gftrtftian  3)tctcnd> 

i  7  6  6. 


Title  page  of  von  Rosenstein.   German  edition. 


380  PEDIATRICS  OF  THE  PAST 

It  is  likewise  observable  that  the  hooping-cough  always  appears  as  an 
epidemical  disease.  I  think  its  nature  is  easily  to  be  understood,  since  I 
have  many  times  plainly  perceived  it  to  be  contagious,  and  that  it 
infects  only  such  children  who  have  not  yet  had  it.  Therefore  it  infects 
in  the  same  manner  as  the  measles  or  small-pox.  I  knew  the  hooping- 
cough  conveyed  from  a  patient  to  two  other  children  in  a  different  house 
by  means  of  an  emissary.  I  have  even  myself  carried  it  from  one  house  to 
another  undesignedly. 

A  person  who  has  once  had  the  hooping-cough  is  as  secure  from  the 
danger  of  catching  that  disorder  again  as  those  who  have  had  the  small- 
pox and  measles  are  with  regard  to  those  respective  diseases.  During  my 
practice  I  never  found  or  heard  of  any  one  who  has  been  infected  with 
the  hooping-cough  more  than  once. 

It  comes  on  only  by  degrees,  and  is  at  first  dry,  but  when  it  has 
continued  ten  or  twelve  days,  it  turns  humid,  and  the  matter  which  is 
then  coughed  up  looks  ripe;  nevertheless  it  increases  more  and  more, 
leaving  long  intervals;  the  fits  return  at  certain  hours,  but  continue  at 
each  time  with  such  violence  and  for  so  long  a  time,  that  the  child 
grows  blue  in  the  face,  its  eyes  look  as  if  they  were  forced  out,  and  they 
run  besides,  and  a  bleeding  of  the  nose  is  sometimes  brought  on;  it 
coughs  till  it  is  quite  out  of  breath,  that  one  is  in  apprehension  of  its 
being  choaked;  for  if  the  patient  now  and  then  is  capable  of  drawing  some 
breath,  it  is  with  a  sounding  which  very  much  indicates  with  what 
difficulty  the  lungs  can  admit  the  air.  The  coughing  continues,  and  does 
not  leave  off  for  that  time,  till  the  child  vomits  up  a  quantity  of  slime. 
If  at  any  time  the  coughing  should  intermit  without  the  paroxysm  being 
ended  with  a  vomiting,  it  will  immediately  return  again,  and  will  not 
cease  but  after  a  vomiting.  If  the  paroxysm  happens  to  come  on  immedi- 
ately after  the  child  has  taken  nourishment,  it  will  grow  blue  in  the  face, 
stumble,  and  be  stifled  if  one  does  not  quickly  excite  vomiting  by  irritat- 
ing its  throat  with  a  finger.  Therefore  such  patients  should  not  be  left 
alone  by  themselves,  but  be  attended  by  a  sensible  person  who  has  a 
presence  of  mind,  and  who  will  besides  be  of  service  in  preventing  them 
from  hurting  themselves,  for  they  will  generally  tumble  down  during  the  fit. 
However,  they  commonly  lay  hold  of  something  when  the  coughing 
seizes  them,  for  instance  a  chair  or  table,  keeping  it  fast  with  all  their 
strength,  whilst  they  during  that  time  are  stamping  with  their  feet.  The 
chincough  is  called  Coqueluche  in  France,  because  they  formerly  thought  it 
to  arise  from  a  running  of  the  head,  and  that  it  was  to  be  cured  by  keep- 
ing the  head  warm  by  a  cap.  We  have  not  received  any  particular  name 
for  the  chincough  from  the  ancient  Romans  and  Greeks,  as  it  was  not 
then  known  to  them. 

It  is  worth  our  while  to  take  this  into  consideration;  for  the  disease  is 
both  tedious  and  severe.  When  it  is  left  to  the  course  of  nature  alone  to 


NILS  ROSfiN  VON  ROSENSTEIN  381 

be  worked  out,  it  commonly  will  last  eleven  or  twelve  weeks,  nay  fre- 
quently half  a  year.  What  is  still  worse,  the  disease  is  very  dangerous 
and  often  fatal.  A  number  of  patients  are  stifled  by  it,  getting  convulsions 
and  apoplexies,  others  pine  away  entirely,  others  again  are  puffed  up  by 
it  and  die.  Besides  a  great  number  contract  ruptures  hereby,  or  become 
deformed. 


WILLIAM  CADOGAN 
[1711-1797] 

TO  truly  estimate  Cadogan,  and  he  looms  large,  one  must  bear 
in  mind  that  he  graced  a  period  when,  as  a  rule,  "the  mind 
like  the  beard  had  a  formal  cut."  The  eighteenth  century 
was  a  formal  age.  Men  bowed  and  scraped  punctiliously  over  their 
snuff  boxes;  the  philosophers  droned  tediously;  even  the  music  of 
the  period  was  precise.  Small  wonder  that  the  medicine  of  the  cen- 
tury followed  suit.  The  medical  London  of  those  days  was  replete 
with  interest;  the  mere  mention  of  a  few  names  suffices  to  give  it 
coloring.  At  that  time  John  Brown  was  flourishing.  A  protege  of 
CuIIen,  he  announced  a  theory  known  as  the  Brunonian,  a  theory 
actually  taken  seriously  for  a  quarter  of  a  century  and  which 
comes  down  to  us  even  until  today  in  the  textbook  use  of  the 
words  sthenic  and  asthenic.  Smellie  was  doing  obstetrics,  the 
Hunters  and  Percival  Pott,  surgery,  and  medicine  was  represented 
by  such  men  as  CuIIen,  the  older  Heberden  and  John  Fothergill, 
when  Cadogan  decided  to  give  up  his  work  in  Bristol  and  move 
up  to  London  to  make  a  place  and  a  name  for  himself. 

Of  this  old  worthy  we  know  but  little:  a  treatise  on  gout, 
an  essay  on  the  nursing  and  nourishment  of  young  children,  and 
his  literary  work  is  nearly  compassed.  But  whilst  he  threw  few 
stones  into  the  pond,  he  created  a  great  splash;  he  used  large 
stones  and  he  flung  with  force. 

The  fact  that  medical  history  was  largely  neglected  by  the 
English  makes  it  difficult  to  supply  interesting  biographical 
facts  about  many  of  her  great  physicians  and  surgeons.  In  many 
cases  one  has  to  read  between  the  lines  of  their  works  to  find  out 
anything  about  the  man.  If  John  Mayow,  one  of  England's 
geniuses,  remained  and  still  remains  practically  unknown,  it  is 
little  wonder  that  William  Cadogan  should  fare  likewise.  There 
may  be  a  wealth  of  biographical  material  about  the  latter,  but 
if  so,  it  is  buried  somewhere  in  an  inaccessible  place.  What  we 
do  know  is  that  he  was  born  in  171 1,  lived  nearly  through  the 
century,  dying  in  1797,  and  was  buried  at  Fulham,  where  he 

382 


A    N 

ESSAY 

UPON 

NURSING 

AND     THE 

Management  of  CHILDREN, 

FROM 

Their  BIRTH  to  Three  Years  of  Age* 

b  y 

W.     CADOGAN, 

Fellow  of  the  COLLEGE  of  PHYSICIANS, 

Late  Physician  to  the  Foundling-hospital. 

In  a  LETTER  to  a  GOVERNOR. 

Published  by  Older  of  the  General  Committee  for  trank&iag 
the  Affairs  of  the  (aid  HofpitaL 

THE     NINTH     EDITION, 
Revifed  and  Corrected  by  the  A  u  t  h  o  r  . 

LONDON: 

Printed  for  Robert  Horsfield,  at  the  Crown  in 

Ludgate-ftreet.     Mdcclxix. 

(Price  One  Shilling.) 
Title  page  of  Cadogan's  "Essay  upon  Nursing." 


384  PEDIATRICS  OF  THE  PAST 

had  a  villa.  His  youth  was  spent  in  Oxford,  where  he  was  gradu- 
ated b.  a.  from  Oriel  College  in  1731.  Electing  to  study  medicine, 
he  visited  the  Continent  and  received  his  doctor's  degree  at 
Leyden  in  1737.  Perhaps  he  was  a  student  of  the  great  Albinus, 
famous  for  his  anatomic  illustrations,  professor  of  anatomy  and 
surgery  in  Leyden  at  that  time.  If  so,  Cadogan  must  have  come 
to  know  of  the  works  of  the  great  masters  Vesalius,  Fabricius 
and  Eustachius.  Or  perhaps  he  studied  anatomy  with  Peter 
Camper,  who  scorned  anatomic  illustrations  and  who  main- 
tained stoutly  that  anatomy  must  be  considered  as  architecture 
and  not  in  surface  drawings. 

But  whatever  his  adventures  on  the  Continent,  we  know  they 
were  soon  over.  After  a  period  of  service  in  the  army,  Cadogan 
settled  in  Bristol,  where  he  resided  in  1752,  in  which  year  he 
was  made  a  Fellow  of  the  Royal  Society.  A  little  later  he  removed 
to  London.  He  was  not  long  in  establishing  himself  and  in  1754 
he  was  made  physician  to  the  Foundling  Hospital.  The  following 
June,  Oxford  made  him  m.  a.,  m.  b.  and  m.  d.,  and  in  1758  the 
College  of  Physicians  did  him  the  honor  of  electing  him  to  mem- 
bership. Four  times  did  he  serve  as  censor  and  twice,  in  1764 
and  1792,  delivered  the  Harveian  oration. 

Cadogan  lived  in  George's  Street,  Cavendish  Square,  under 
the  shadow  of  St.  George's  Church,  famous  as  a  place  of  fashion- 
able weddings.  Mr.  Roosevelt  was  married  there  in  1886,  George 
Eliot  in  1880,  and  more  interesting  still,  Sir  William  Hamilton 
to  Emma  Hart  in  1791.  If  you  do  not  know  the  story  of  Lady 
Emma  you  still  have  something  to  live  for.  But  all  this  is  by  the 
way.  Cadogan's  portrait  by  R.  E.  Pine  adorns  the  walls  of  the 
College  of  Physicians,  and  notes  about  him  are  to  be  found  in 
Munk's  "Roll  of  the  College  of  Physicians,"  Nichol's  "Anec- 
dotes," and  The  Gentleman's  Magazine  for  1 797. 

His  principal  works  are  on  gout  and  children.  The  first  is 
entitled  "A  Dissertation  on  the  Gout,  and  all  Chronic  Diseases, 
jointly  considered,  as  proceeding  from  the  same  causes,  what 
those  causes  are;  and  a  rational  Method  of  Cure  Proposed. 
Addressed  to  all  Invalids.  Quod  petris  in  te  est.  London,  1771." 
This  was  widely  read  and  went  through  ten  editions  in  two  years. 

The  other  was  "An  Essay  upon  Nursing,  and  the  Management 
of  Children,  London,  1750,"  of  which  nine  editions  appeared  in 
twenty  years. 


William  Cadogan 

[1711-1797] 


WILLIAM  CADOGAN  385 

The  little  book  on  gout,  which  sold  for  one  shilling  and 
sixpence,  starts  off  in  the  preface  with  a  quotation  from  St. 
Evremond,  "To  enjoy  good  health  is  better  than  to  command 
the  world. "  He  continues,  in  a  style  that  is  about  the  easiest 
reading  one  ever  finds  in  a  medical  book,  to  note  that  "health, 
like  time,  becomes  valuable  only  when  it  is  lost,"  and  that  it  is 
strange  that  so  many  "should  pursue,  with  the  same  vain  hope, 
after  repeated  disappointments,  the  thousand  and  ten  thousand 
idle  arts  and  tricks  of  medication  and  quackery;  never  once 
lifting  up  their  eyes  to  Nature,  or  consulting  her  book,  open  as 
it  lies  for  the  perusal,  conviction  and  benefit  of  all." 

Space  prevents  an  examination  of  this  interesting  essay; 
suffice  it  to  say  that  he  regarded  gout  as  curable,  but  not  by 
medical  means.  The  causes  he  sets  down  are  indolence,  intem- 
perance and  vexation,  and  the  cure  is  to  be  found  in  activity, 
temperance  and  peace  of  mind.  All  this  is  fully  explained  with 
succint  comment.  It  seems  a  little  strange  (unless  one  pauses) 
to  read:  "  I  recommend  it  to  all  men  to  wash  their  feet  every  day." 
But  we  must  not  tarry  here.  The  book  set  London  agog.  It  was 
followed  by  a  number  of  other  publications.  An  anonymous 
"Candid  Enquiry  into  the  Merits  of  Dr.  Cadogan's  Disserta- 
tion on  the  Gout"  is  a  readable,  satiric  article,  thrice  as  long 
as  the  original. 

One  comment  in  this  tract  may  throw  some  light  on  why 
Cadogan's  ideas  provoked  so  much  discussion,  as  well  as  on  the 
life  of  the  time  and  the  wit  of  the  author. 

If  I  am  not  mistaken  the  laudable  qualities,  which  are  at  present  the 
most  in  fashion,  are  keeping  mistresses,  debauching  friends'  wives, 
cheating  at  gaming  tables  and  at  Newmarket,  indulging  in  every  excess 
and  refinement  in  eating  and  drinking,  and  speaking  in  Parliament. 

William  Falconer  of  Bath,  William  Carter,  Mr.  Daniel 
Smith  and  others  published  tracts  about  Cadogan's  dissertation, 
but  one  gathers  that  they  did  him  more  good  than  harm. 

The  last  part  of  his  preface  contains  a  sort  of  conjessio  medici: 

I  think  a  real  Physician  the  most  liberal  of  characters  upon  the  earth, 
by  which  I  do  not  mean  every  Doctor  that  goes  about  taking  guineas, 
but  him  who  will  neither  flatter  the  great  nor  deceive  the  ignorant,  and 
who  would  prefer  the  satisfaction  of  making  one  invalid  a  healthy  man; 
to  the  wealth  of  RadcIifF  or  the  vogue  of  Wood.  But  there  is  an  evil 


386  PEDIATRICS  OF  THE  PAST 

spirit  of  quackery  gone  forth,  that  has  possessed  all  orders  of  men  among 
us.  I  would  lay  it,  if  I  could,  together  with  every  demon  of  superstition 
and  error,  and  restore  the  world  to  Truth  and  Nature. 

To  which  the  author  of  a  "Candid  Enquiry"  replies: 

For  the  rational  attempt,  unrevealed  and  untried  before,  is  perfectly 
accomplished  by  Dr.  Cadogan.  Burn  the  books  of  Hippocrates,  Galen, 
Celsus,  Sydenham,  Musgrave,  Boerhaave,  Hoffman,  and  all  other  rub- 
bish of  Greek,  Latin,  Arabic  and  modern  physicians.  And  then,  let  every 
regular,  semiregular  and  irregular  practitioner,  whether  he  be  mounted 
in  a  chariot,  on  a  stage  or  walk  on  foot;  whether  he  advertise  his  medi- 
cines or  himself,  be  hanged.  Yes,  my  good  readers,  hang  Wintringham, 
hang  Heberden,  hang  Adington;  but  for  honest  Will.  Cadogan,  real  Will. 
Cadogan,  liberal  Will.  Cadogan,  rational  Will.  Cadogan,  and  therefore  the 
more  rational,  being  as  he  is,  new  Will.  Cadogan,  hang  not  him;  save 
honest  Will,  and  hang  all  the  rest. 

Far  more  interesting  is  the  clever  poem  published  anony- 
mously, entitled,  "The  Doctor  Dissected:  or  Willy  Cadogan  in 
the  Kitchen.  Addressed  to  all  Invalids  and  Readers  of  a  late 
Dissertation  on  the  Gout,  etc.  etc.  etc.  By  a  Lady.  'The  best  of 
all  Doctors  is  sweet  Willy  0/  "  The  lady  in  question  was  a  Mrs. 
Ireland.  This  poem  is  really  a  very  good  review  of  Cadogan's 
Essay  and  pity  it  is  that  space  prevents  reprinting  it  in  its  entirety. 

The  Town  are  half  mad  (you  have  heard  without  doubt) 

For  a  book  that  is  called  Dissertation  on  Gout, 

That  king  of  diseases,  no  longer  endure, 

Adhere  to  its  rules — see  a  radical  cure! 

But  alas!  cou'd  Lebeck  or  poor  Cbloe  but  know, 

What  a  penance,  it  says,  we  must  all  undergo, 

The  author,  to  Styx,  in  a  sulphurous  flame, 

They'd  waft,  and  extirpate  the  breed  and  the  name: 

But,  lest  the  poor  wight,  shou'd  oblivion  lie  snug  in, 

Without  further  preface — 'tis  Willy  Cadogan. 

Regardless  of  profit,  not  studious  to  please, 

Tho'  deck'd  in  long  wig,  and  enrich'd  with  degrees, 

He,  in  two-fold  capacity,  there  does  appear, 

And  hopes  ( — for  our  health's  sake,)  we'd  lend  him  an  ear: 

As  doctor,  and  cook, — no  disgrace  to  the  college, 

For,  troth,  he  lay's  open  a  wide  field  of  knowledge. 

He  tells  us,  at  once,  in  a  manner  laconic, 

"That  all  the  diseases  the  learned  term  chronic, 


WILLIAM  CADOGAN  387 

"From  intemp'rance,  vexation,  and  indolence  claim, 
"Their  rise,  and  their  first  introduction  to  fame." 
But  declin'd  in  his  practice,  this  wonderful  scapin 
Treats  on  cul'nary  arts,  and  cries  down  ^Esculapian. 

"The  gout,  a  disease  now  so  common  is  grown, 

"There  scarce  lives  a  man,  but  its  twinges  has  known; 

"Or,  say  he  shou'd  not,  full  as  well  can  explain, 

"Its  cause,  and  its  several  stages  of  pain": 

Unless,  to  the  stomach,  it  chance  to  get  clear  in, 

And  then,  he'll  pronounce  you — as  dead  as  a  herring.    .    . 

"But  wou'd  ye  to  fam'd  Epictetus  adhere, 
"Whose  philosophy  teaches  to  bear  and  forbear, 
"You'd  find  in  good  health,  at  a  hundred  and  twenty" 
Maids,  widows,  and  batchelors — Deo  favente. 

Of  the  days  of  good  Adam,  our  grandsire,  he'd  sing, 
Who  fed  on  the  herb,  and  who  drank  from  the  spring; 
'Till  Eve, — wicked  jade! — for  an  apple  so  rare, 
Entail'd  on  posterity  ages  of  care: 
Which  apple,  they  say,  was  in  semblance  so  fine, 
It  cou'd  be  no  other  I  guess — than  a  Pine. — 

Excuse  the  digression — to  palliate  I  strove, 
The  sin  of  first  parents,  since  most  of  ye  love, 
To  partake  of  this  fruit, — and  if  tempted  by  Eve, — 
Not  a  man  of  ye  all, — but  wou'd  Paradise  leave. 

This  first  state  of  nature  you  now  must  pursue, 

"For  medical  aid,  it  is  plain,  will  not  do; 

"Use  manual  labor,  walk  many  a  mile, 

"Or  pester'd  you'll  be, — with  gout,  cholic,  and  bile." 

For  nature  alone  by  brisk  exercise  thrives, 

A  new  lease  it  will  give  the  most  desperate  lives. 

Scrub  tables,  clean  pewter,  and  dry-rub  your  rooms, — 

He'll  furnish  with  bees-wax,  mops,  brushes  and  brooms: 

And  rather  than  not  set  your  blood  in  a  fluster, — 

I'll  venture  to  promise, — to  each  a  clean  duster. 

"  Indiscriminate  action,  makes  shocking  confusion, 
"But  lest  you  are  puzzled  to  find  an  allusion; 
"Like  the  sun  'fore  the  moon,  and  the  moon  'fore  the  sun, 
"Chyle,  serum,  lymph,  blood, — shou'd  in  due  order  run." 


388  PEDIATRICS  OF  THE  PAST 

"Beware  of  pretenders  to  physical  myst'ry, 

"Nor  let  'em  phlebotomize,  sweat,  or  e'en  blister  ye, 

"Avoid,  like  a  pestilence,  ignorant  Quacks, 

"From  those  in  gilt  chariots," — to  plain  simple  hacks. 

Disciples  of  Galen,  all  shut  up  your  shops, 

No  need,  have  we  now,  of  your  balsams  or  drops; 

"Dear  volatiles,  cordials,  and  bracers,"  adieu! 

Ye  all  must  give  place,  to  a  system  quite  new. 

"The  physical  art,  above  two  thousand  years, 

"We  find  has  been  practis'd" — he  tells  it  with  tears: 

With  tears  that  so  deep,  on  his  paper  are  sinking, 

He  scarcely  can  scribble, — for  winking,  and  blinking: 

But  bar  all  reflection, — (fond  sorrow  adieu!) 

The  secrect  must  out,  and  'tis  fatally  true! 

"No  one  certain  remedy,  e'er  has  been  found, 

"For  any  disease  that  exists  above  ground!" 

Thus  each  invalid,  will  proof  positive  find, 

That  the  lame  must  be  lame,  and  the  blind,  still  be  blind. 

But,  for  fear  you'd  suspect  his  poor  head  is  quite  addle, 

With  quacking  Le  Fevre  he  once  does  not  meddle. 

"From  plain  decorations  on  table,  when  seen, 
"We  never  suspect  any  ill,  so  I  ween: 
"Salt,  mustard,  and  pepper,  ay!  vinegar  too, 
"Are  quite  as  unwholesome  as  pudding  I  vow; 
"And  bread,"  the  main  staff  of  our  Life,  he  does  call, 
"No  more,  nor  no  less — than  the  worst  thing  of  a//."   .    . 

"If  sauce  and  provocatives,  thus  you  will  sip  up, 

"No  wonder  you're  plagu'd  with  a  sour  bitter  hiccup": 

And  'tho,  as  you  think,  to  procure  good  digestion, 

A  mouthfull  of  cheese  is  the  best  thing  in  question : 

"In  Gatb  do  not  tell,  nor  in  Askalon  blab  it" — 

(You're  strictly  forbidden  to  eat  a  welch  rabbit) 

Excuse  me,  dear  doctor,  nor  deem  it  a  fault, 

Is  seas'ning  denied,  I  should  try  attic  salt: 

This  indulgence  I  crave,  absolution  pray  give; 

And  I'll  honour  your  maxims  as  long  as  I  live. 

Good  spice  he  condemns,  and  what's  very  queer 

"He  prohibits  all  liquors,  excepting  small  beer": 

Objects  to  their  quality,  hints  that,  sans  useing  'em, 

We  may  live,  if  we  please,  to  the  age  of  Methusalem.   .    . 


WILLIAM  CADOGAN  389 

Ye  homeward  bound  Indiamen — wou'd  you  could  hear!  ah! 

At  some  foreign  port,  land  your  spice  and  Madeira, 

One  pint  of  soft  water,  that  liquor  divine, 

Is  better,  far  better,  than  hogsheads  of  wine: 

"But  for  company's  sake, — and  the  doctor's  a  trimmer! 

One  day  in  a  month, — he'll  allow  us  a  brimmer."   .    .    . 

"  Physicians,  I  beg,  of  all  rank,  and  degrees, 

"You'll  learn  the  new  method  of  getting  your  fees: 

"Politeness  discard,  and  adopt  in  its  stead, 

"The  manner  now  practis'ed  of  being  well  bred: 

"Tell  your  patients  their  folly  deprives  them  of  health." 

And  prefer  honest  bluntness  to  fame  and  to  wealth : 

That,  in  fact,  you  as  soon  can  eradicate  pain, 

As  prevent  a  man  breaking  his  neck  in  years  twain.   .    .    . 

But  if  cholic,  nor  vapors,  our  frame  shou'd  affect; 

Adieu!  to  the  practice  of  doctors  elect: 

You'd  best  then,  remain  sirs,  aut  Caesar,  aut  Nullus, 

Of  our  money  and  lives,  with  formality,  cull  us; 

Nay,  I'll  not  mince  the  matter, — in  troth  I  hate  lying — 

"In  minimis"  take  it — you  live  by  our  dying. 

Stella. 

Cadogan's  views  on  the  relation  of  gout  and  wine  worried  the 
nation,  just  as  they  are  worried  today  by  the  propagandists  of 
the  Anti-Saloon  League,  and  one  of  his  adversaries  quotes  the 
old  quip: 

There  are,  my  friend,  if  right  I  think, 

But  five  good  reasons  why  I  drink; 

Good  wine,  a  friend,  or  being  dry, 

Or  lest  I  should  be  by  and  by, 

Or  any  other  reason  why. 

The  "Candid  Enquiry"  also  contains  the  following  anent  the 
same  subject: 

And  now  for  the  comment  of  the  Evangelist. 

St.  Paul  advises  it  as  a  medicine  sometimes;  but  certainly  not  every 
day.  But  by  the  doctor's  permission,  let  St.  Paul  speak  for  himself. 
"Drink  no  longer  water,  but  a  little  wine  for  tby  Stomach  sake,  and  thine 
own  infirmities."  Now  does  the  saint  advise  a  little  wine  only  as  a  medi- 
cine, sometimes,  when  he  bids  Timothy  drink  no  longer  water?  what  was 
there  for  him  to  drink  besides  wine,  when  water  was  interdicted  in  a 


390  PEDIATRICS  OF  THE  PAST 

country  that  produced  no  other  than  these  two  liquors  for  general  usage? 
St.  Paul,  therefore,  is  as  much  forgotten  as  Hippocrates,  Aretaeus, 
Celsus,  Sydenham,  Musgrave,  Boerhaave,  Hoffman  and  others;  and 
the  doctor  is  equally  new,  by  dint  of  oblivion,  in  divinity  as  in  physic. 
For  no  man  surely  can  harbour  a  single  thought  that  Dr.  Cadogan  hath 
not  read  the  Bible.  And  now  I  will  ask,  if  there  can  be  any  man  mad 
enough  to  renounce  the  Apostle  and  believe  in  the  Doctor  of  Physic. 
Credat  judaeus  non  ego. 

The  Essay  on  Nursing  is  well  worth  perusal,  but  in  lieu  of 
that,  the  following  extracts  will  give  one  a  fair  idea  of  the  con- 
tents and  style.  It  is  a  little  brochure,  forty-two  octavo  pages 
long,  published  by  the  order  of  the  General  Committee  of  the 
Foundling  Hospital,  to  be  sold  at  a  sixpence.  It  starts  off  in 
characteristic  fashion : 

It  is  with  great  Pleasure  I  see  at  last  the  Preservation  of  Children 
become  the  Care  of  Men  of  Sense:  It  is  certainly  a  matter  which  well 
deserves  their  Attention,  and  I  doubt  not,  the  Publick  will  soon  find  the 
good  and  great  Effects  of  it. 

It  would  not  be  amiss  to  print  the  whole  Essay,  for  what  he 
says  is  said  today  by  hundreds  of  different  agencies :  a  few  selec- 
tions must  suffice.  Let  us  examine  them  and  what  do  we  find? 
A  real  man,  a  very  human  being  and  one  who  needs  no  com- 
mentator. Do  you  know  anyone  who  has  drawn  a  picture  of  the 
"poor  little  rich  child "  and  the  "rich  little  poor  child,"  better 
than  he?  Read  it  again  if  you  do  not  know  it  and  see  the  advan- 
tage of  the  comparative  poverty  of  the  laborious.  Unfortunately, 
the  spirit  of  imitation  is  so  strong  that  nowadays  the  wealthier 
are  apt  to  have  the  better  of  it  if  they  have  common  sense  enough 
to  take  advantage  of  their  blessings,  which  they  often  have  not. 

In  the  lower  class  of  Mankind,  especially  in  the  country,  disease 
and  mortality  are  not  so  frequent,  either  among  adults  or  their  children. 
Health  and  posterity  are  the  portion  of  the  poor,  I  mean  the  laborious. 
The  want  of  superfluity  confines  them  more  within  the  limits  of  Nature: 
hence  they  enjoy  blessings  they  feel  not,  and  are  ignorant  of  their  cause. 
The  mother  who  has  only  a  few  rags  to  cover  her  child  loosely,  and  little 
more  than  her  own  breast  to  feed  it,  sees  it  healthy  and  strong,  and  very 
soon  able  to  shift  for  itself;  while  the  puny  insect,  the  heir  and  hope  of  a 
rich  family,  lies  languishing  under  a  load  of  finery  that  overpowers  his 
limbs,  abhorring  and  rejecting  the  dainties  he  is  crammed  with,  till  he 
dies  a  victim  to  the  mistaken  care  and  tenderness  of  his  fond  Mother. 


WILLIAM  CADOGAN  391 

In  all  the  wealth  of  propagandist  literature  of  the  numerous 
agencies  for  child  welfare  and  the  prevention  of  infant!  mortality, 
one  has  yet  to  see  the  name  of  Cadogan.  And  this,  when  no  one 
else  has  ever  put  the  case  and  its  necessities  more  strongly. 
Pemell  and  others  raised  a  weak  voice  and  tried  to  help,  but  the 
stage  was  not  ready  and  the  appeal  fell  on  deaf  ears.  Pemell 
has  been  forgotten.  Cadogan  shouts  with  no  uncertain  voice; 
he  made  himself  heard  and  started  the  ball  rolling.  Others  have 
pushed  it  along  and  now  thousands  of  workers  are  helping;  not 
all  push  in  the  same  direction,  the  progress  is  not  as  rapid  as  it 
should  be,  but  the  intention  is  good  if  some  of  the  zeal  be  mis- 
directed. The  proof  of  the  work  is  still  in  the  mortality  bills.  The 
rates  are  going  down.  One  hopes  then  to  see  proper  respect 
given  Cadogan  by  the  uplifters  as  well  as  by  pediatrists.  Would 
not  this  sentence  go  as  well  today  as  when  it  was  written?  A 
good  test,  sometimes  a  fallacious  one,  but  one  that  seems  to  work 
in  this  instance. 

When  a  man  takes  upon  him  to  contradict  received  opinions  and 
prejudices  sanctified  by  time,  it  is  expected  he  should  bring  valid  proof 
of  what  he  advances.  The  truth  of  what  I  say,  that  the  treatment  of 
Children  in  general  is  wrong,  unreasonable,  and  unnatural,  will  in  a 
great  measure  appear,  if  we  but  consider  what  a  puny  valetudinary  race 
most  of  our  people  of  condition  are;  chiefly  owing  to  bad  nursing,  and 
bad  habits  contracted  early.  But  let  any  one,  who  would  be  fully  con- 
vinced of  this  matter,  look  over  the  BILLS  OF  MORTALITY;  there  he 
may  observe,  that  almost  half  the  number  of  those  who  fill  up  that  black 
list,  die  under  five  years  of  age:  so  that  half  the  people  that  come  into 
the  world,  go  out  of  it  again  before  they  become  of  the  least  use  to  it, 
or  themselves.  To  me  this  seems  to  deserve  serious  consideration;  and 
yet  I  cannot  find,  that  any  one  man  of  sense  and  publick  spirit  has  ever 
attended  to  it  at  all;  notwithstanding  the  maxim  in  every  one's  mouth, 
that  a  multitude  of  inhabitants  is  the  greatest  strength  and  best  support 
of  a  Commonwealth. 

From  the  poor  to  the  abuses  of  the  rich  is  but  a  step;  listen 
again  to  our  worthy  author. 

You  perceive,  Sir,  by  the  hints  I  have  already  dropped,  what  I 
am  going  to  complain  of  is,  that  Children  in  general  are  over-cloathed 
and  over-fed;  and  fed  and  cloathed  improperly.  To  these  causes  I  impute 
almost  all  their  diseases.  But  to  be  a  little  more  explicit.  The  first  great 
mistake  is,  that  they  think  a  new-born  infant  cannot  be  kept  too  warm : 


1/ 


392  PEDIATRICS  OF  THE  PAST 

from  this  prejudice  they  load  and  bind  it  with  flannels,  wrappers, 
swathes,  stays,  &c.  which  altogether  are  almost  equal  to  it's  own  weight; 
by  which  means  a  healthy  Child  in  a  month's  time  is  made  so  tender  and 
chilly,  it  cannot  bear  the  external  air;  and  if,  by  any  accident  of  a  door 
or  window  left  carelessly  open  too  long,  a  refreshing  breeze  be  admitted 
into  the  suffocating  atmosphere  of  the  lying-in  bed-chamber,  the  child  and 
Mother  sometimes  catches  irrecoverable  colds.  But,  what  is  worse  than 
this,  at  the  end  of  the  month,  if  things  go  on  apparently  well,  this  hot-bed 
plant  is  sent  out  into  the  country  to  be  reared  in  a  leaky  house,  that  lets 
in  wind  and  rain  from  every  quarter.  Is  it  any  wonder  the  child  never 
thrives  afterwards?  The  truth  is,  a  new-born  Child  cannot  well  be  too 
cool  and  loose  in  its  dress;  it  wants  less  cloathing  than  a  grown  person 
in  proportion,  because  it  is  naturally  warmer,  as  appears  by  the  ther- 
mometer, and  would  therefore  bear  the  cold  of  a  winter's  night  much 
better  than  any  adult  person  whatever.  There  are  many  instances,  both 
antient  and  modern,  of  infants  exposed  and  deserted,  that  have  lived 
several  days.  As  it  was  the  practice  of  antient  times,  in  many  parts  of 
the  world,  to  expose  all  those  whom  the  parents  did  not  care  to  be 
incumbered  with;  that  were  deformed,  or  born  under  evil  stars;  not  to 
mention  the  many  Foundlings  picked  up  in  LONDON  streets.  These 
instances  may  serve  to  shew,  that  Nature  has  made  Children  able  to 
bear  even  great  hardships,  before  they  are  made  weak  and  sickly  by 
their  mistaken  Nurses.  But,  besides  the  mischief  arising  from  the  weight 
and  heat  of  these  swaddling-cloaths,  they  are  put  on  so  tight,  and  the 
Child  is  so  cramped  by  them,  that  its  bowels  have  not  room,  nor  the 
limbs  any  liberty,  to  act  and  exert  themselves  in  the  free  easy  manner 
they  ought.  This  is  a  very  hurtful  circumstance;  for  limbs  that  are  not 
used  will  never  be  strong,  and  such  tender  bodies  cannot  bear  much 
pressure:  the  circulation  restrained  by  the  compression  of  any  one  part, 
must  produce  unnatural  swellings  in  some  other;  especially  as  the  fibres 
of  infants  are  so  easily  distended.  To  which  doubtless  are  owing  the  many 
distortions  and  deformities  we  meet  with  every- where;  chiefly  among 
Women,  who  suffer  more  in  this  particular  than  the  Men. 

Do  you  like  the  natural  method  of  things?  Cadogan  was  no 
lover  of  artifices.  The  complete  freedom  of  the  child  from  those 
troublesome  restraints,  complained  of  too  by  Felix  Wiirtz,  was 
his  hobby,  and  he  rode  it  well.  And  he  insisted  on  clean  clothes 
for  infants!  His  notes  on  feeding  are  interesting  and  full  of  good, 
sound  sense. 

I  would  recommend  the  following  dress:  A  little  flannel  waistcoat, 
without  sleeves,  made  to  fit  the  body,  and  tie  loosely  behind;  to  which 
there  should  be  a  petticoat  sewed,  and  over  this  a  kind  of  gown  of  the 


WILLIAM  CADOGAN  393 

same  material,  or  any  other  that  is  light,  thin,  and  flimsey.  The  petticoat 
should  not  be  quite  so  long  as  the  Child,  the  gown  a  few  inches  longer; 
with  one  cap  only  on  the  head,  which  may  be  made  double,  if  it  be 
thought  not  warm  enough.  What  I  mean  is,  that  the  whole  coiffure 
should  be  so  contrived,  that  it  might  be  put  on  at  once,  and  neither  bind 
nor  press  the  head  at  all:  the  linen  as  usual.  This  I  think  would  be 
abundantly  sufficient  for  the  day;  laying  aside  all  those  swathes,  band- 
ages, stays,  and  contrivances,  that  are  most  ridiculously  used  to  close 
and  keep  the  head  in  it's  place,  and  support  the  body.  As  if  Nature, 
exact  Nature,  had  produced  her  chief  work,  a  human  creature,  so  care- 
lessly unfinished  as  to  want  those  idle  aids  to  make  it  perfect.  Shoes 
and  stockings  are  very  needless  incumbrances,  besides  that  they  keep 
the  legs  wet  and  nasty,  if  they  are  not  changed  every  hour,  and  often 
cramp  and  hurt  the  feet:  a  child  would  stand  firmer,  and  learn  to  walk 
much  sooner  without  them.  I  think  they  cannot  be  necessary  till  it 
runs  out  in  the  dirt.  There  should  be  a  thin  flannel  shirt  for  the  night, 
which  ought  to  be  every  way  quite  loose.  Children  in  this  simple,  pleas- 
ant dress,  which  may  be  readily  put  on  and  off  without  teazing  them, 
would  find  themselves  perfectly  easy  and  happy,  enjoying  the  free 
use  of  their  limbs  and  faculties,  which  they  would  very  soon  begin  to 
employ  when  they  are  thus  left  at  liberty.  I  would  have  them  put  into 
it  as  soon  as  they  are  born,  and  continued  in  it  till  they  are  three  years 
old;  when  it  may  be  changed  for  any  other  more  genteel  and  fashionable: 
tho'  I  could  wish  it  was  not  the  custom  to  wear  stays  at  all;  not  because 
I  see  no  beauty  in  the  sugar-loaf  shape,  but  that  I  am  apprehensive 
it  is  often  procured  at  the  expence  of  the  health  and  strength  of  the  body. 
There  is  an  odd  notion  enough  entertained  about  change,  and  the  keeping 
of  children  clean.  Some  imagine  that  clean  linen  and  fresh  cloaths  draw, 
and  rob  them  of  their  nourishing  juices.  I  cannot  see  that  they  do  any 
thing  more  than  imbibe  a  little  of  that  moisture  which  their  bodies 
exhale.  Were  it,  as  is  supposed,  it  would  be  of  service  to  them;  since  they 
are  always  too  abundantly  supplied,  and  therefore  I  think  they  cannot 
be  changed  too  often,  and  would  have  them  clean  every  day;  as  it  would 
free  them  from  stinks  and  sournesses,  which  are  not  only  offensive,  but 
very  prejudicial  to  the  tender  state  of  infancy. 

The  feeding  of  Children  properly  is  of  much  greater  importance  to 
them  than  their  cloathing.  We  ought  to  take  great  care  to  be  right 
in  this  material  article,  and  that  nothing  be  given  them  but  what  is 
wholesome  and  good  for  them,  and  in  such  quantity  as  the  body  calls 
for  towards  it's  support  and  growth;  not  a  grain  more.  Let  us  consider 
what  Nature  directs  in  the  case:  if  we  follow  Nature,  instead  of  leading 
or  driving  it,  we  cannot  err.  In  the  business  of  Nursing,  as  well  as  Physick, 
Art  is  ever  destructive,  if  it  does  not  exactly  copy  this  original.  When  a 


394  PEDIATRICS  OF  THE  PAST 

Child  is  first  born,  there  seems  to  be  no  provisions  at  all  made  for  it; 
for  the  Mother's  milk,  as  it  is  now  managed,  seldom  comes  till  the  third 
day;  so  that  according  to  this  appearance  of  Nature  a  Child  would  be 
left  a  day  and  a  half,  or  two  days,  without  any  food.  Were  this  really 
the  case,  it  would  be  a  sufficient  proof  that  it  wanted  none;  as  indeed 
it  does  not  immediately;  for  it  is  born  full  of  blood,  full  of  excrement,  it's 
appetites  not  awake,  nor  it's  senses  opened;  and  requires  some  inter- 
mediate time  of  abstinence  and  rest  to  compose  and  recover,  the  struggle 
of  the  birth  and  the  change  of  circulation  (the  blood  running  into  new 
channels),  which  always  put  it  into  a  little  fever.  However  extraordinary 
this  might  appear,  I  am  sure  it  would  be  better  that  the  Child  was  not 
fed  even  all  that  time,  than  as  it  generally  is  fed;  for  it  would  sleep  the 
greatest  part  of  the  time,  and,  when  the  milk  was  ready  for  it,  would 
be  very  hungry,  and  suck  with  more  eagerness;  which  is  often  necessary, 
for  it  seldom  comes  freely  at  first.  But  let  me  endeavour  to  reconcile 
this  difficulty,  that  a  Child  should  be  born  thus  apparently  unprovided 
for.  I  say  apparently,  for  in  reality  it  is  not  so.  Nature  neither  intended 
that  a  Child  should  be  kept  so  long  fasting,  nor  that  we  should  feed  it 
for  her.  Her  design  is  broke  in  upon,  and  a  difficulty  raised  that  is  wholly 
owing  to  mistaken  management.  The  Child,  as  soon  as  it  is  born,  is 
taken  from  the  Mother,  and  not  suffered  to  suck  till  the  Milk  comes  of 
itself;  but  is  either  fed  with  strange  and  improper  things,  or  put  to  suck 
some  other  Woman,  whose  Milk  flowing  in  a  full  stream,  overpowers  the 
newborn  infant,  that  has  not  yet  learnt  to  swallow,  and  sets  it  a  coughing, 
or  gives  it  a  hiccup;  the  Mother  is  left  to  struggle  with  the  load  of  her 
Milk,  unassisted  by  the  sucking  of  the  Child.  Thus  two  great  evils  are 
produced,  the  one  a  prejudice  to  the  Child's  health,  the  other,  the  danger 
of  the  Mother's  life,  at  least  the  retarding  her  recovery,  by  causing  what 
is  called  a  milk-fever;  which  has  been  thought  to  be  natural,  but  so  far 
from  it,  that  it  is  entirely  owing  to  this  misconduct.  I  am  confident, 
from  experience,  that  there  would  be  no  fever  at  all,  were  things  managed 
rightly;  were  the  Child  kept  without  food  of  any  kind,  till  it  was  hungry, 
which  it  is  impossible  it  should  be  just  after  the  birth,  and  then  applied 
to  the  Mother's  breasts;  it  would  suck  with  strength  enough,  after  a 
few  repeated  trials,  to  make  the  milk  flow  gradually,  in  due  proportion 
to  the  Child's  unexercised  faculty  of  swallowing,  and  the  call  of  it's 
stomach.  Thus  the  Child  would  not  only  provide  for  itself  the  best  of 
nourishment,  but,  by  opening  a  free  passage  for  it,  would  take  off  the 
Mother's  load,  as  it  increased,  before  it  could  oppress  or  hurt  her;  and 
therefore  effectually  prevent  the  fever;  which  is  caused  only  by  the 
painful  distension  of  the  lacteal  vessels  of  the  breasts,  when  the  milk  is 
injudiciously  suffered  to  accumulate.    .    .    . 

There  is  usually  milk  enough  with  the  first  Child:  sometimes  more 
than  it  can  take:  it  is  poured  forth  from  an  exuberant,  overflowing  urn, 


WILLIAM  CADOGAN  395 

by  a  bountiful  hand,  that  never  provides  sparingly.  The  call  of  Nature 
should  be  waited  for  to  feed  it  with  any  thing  more  substantial,  and  the 
appetite  ever  precede  the  food;  not  only  with  regard  to  the  daily  meals, 
but  those  changes  of  diet,  which  opening,  increasing  life  requires.  But 
this  is  never  done  in  either  case,  which  is  one  of  the  greatest  mistakes 
of  all  Nurses.  Thus  far  Nature,  if  she  be  not  interrupted,  will  do  the 
whole  business  perfectly  well;  and  there  seems  to  be  nothing  left  for  a 
Nurse  to  do,  but  to  keep  the  Child  clean  and  sweet,  and  to  tumble  and 
toss  it  about  a  good  deal,  play  with  it,  and  keep  it  in  good  humour. 

When  the  Child  requires  more  solid  sustenance,  we  are  to  enquire 
what,  and  how  much,  is  most  proper  to  give  it.  We  may  be  well  assured, 
there  is  a  great  mistake  either  in  the  quantity  or  quality  of  Children's 
food,  or  both,  as  it  is  usually  given  them;  because  they  are  made  sick 
by  it;  for  to  this  mistake  I  cannot  help  imputing  nine  in  ten  of  all  their 
diseases    .    .    . 

It  is  not  common  for  people  to  complain  of  ails  they  think  hereditary, 
'till  they  are  grown  up;  that  is,  'till  they  have  contributed  to  them  by 
their  own  irregularities  and  excesses,  and  then  are  glad  to  throw  their 
own  faults  back  upon  their  Parents,  and  lament  a  bad  constitution, 
when  they  have  spoiled  a  very  good  one. 

Anyone  who  has  seen  the  modern  slaughter  of  the  innocents 
in  the  various  infant  asylums,  the  slow  dying  of  a  doomed  baby, 
will  agree  with  what  Cadogan  has  to  say  about  the  day  nursing 
of  infants  and  applaud  the  certain,  questionable  practice  of  the 
Ancients  to  which  he  alludes.  Surely,  the  present  age  has  nothing 
on  Herod,  if  one  may  be  permitted  to  slip  into  the  vulgar  way  of 
expressing  it.  Walker's  "Traffic  in  Babies''  may  be  mentioned  in 
this  connection. 

The  Child,  was  it  nursed  this  way,  would  be  always  quiet,  in  good 
humour,  ever  playing,  laughing,  or  sleeping.  In  my  opinion,  a  Man  of 
sense  cannot  have  a  prettier  rattle  (for  rattles  he  must  have  of  one  kind 
or  other)  than  such  a  young  Child.  I  am  quite  at  a  loss  to  account  for  the 
general  practice  of  sending  infants  out  of  doors,  to  be  suckled  or  dry- 
nursed  by  another  Woman,  who  has  not  so  much  understanding,  nor 
can  have  so  much  affection  for  it  as  the  Parents;  and  how  it  comes  to  pass, 
that  people  of  good  sense  and  easy  circumstances  will  not  give  themselves 
the  pains  to  watch  over  the  health  and  welfare  of  their  Children;  but  are 
so  careless  as  to  give  them  up  to  the  common  methods,  without  con- 
sidering how  near  it  is  to  an  equal  chance,  that  they  are  destroyed  by 
them.  The  antient  custom  of  exposing  them  to  wild  beasts,  or  drowning 


396  PEDIATRICS  OF  THE  PAST 

them,  would  certainly  be  a  much  quicker  and  more  humane  way  of 
dispatching  them.  There  are  some,  however,  who  wish  to  have  Children, 
and  to  preserve  them,  but  are  mistaken  in  their  cares  about  them.  To 
such  only  would  I  address  myself,  and  earnestly  recommend  it  to  every 
Father  to  have  his  Child  nursed  under  his  own  eye,  to  make  use  of  his 
own  reason  and  sense  in  superintending  and  directing  the  management 
of  it;  nor  suffer  it  to  be  made  one  of  the  mysteries  of  the  Bona  Dea,  from 
which  the  Men  are  to  be  excluded.  I  would  advise  every  Mother  that 
can,  for  her  own  sake,  as  well  as  her  Child's,  to  suckle  it.  If  she  be  a 
healthy  Woman,  it  will  confirm  her  health;  if  weakly,  in  most  cases  it 
will  restore  her.  It  need  be  no  confinement  to  her,  or  abridgment  of  her 
time;  four  times  in  four  and  twenty  hours  will  be  often  enough  to  give 
it  suck;  letting  it  have  as  much  as  it  will  take  out  of  both  breasts  at  each 
time.  It  may  be  fed  and  dressed  by  some  handy  reasonable  servant,  that 
will  submit  to  be  directed;  whom  likewise  it  may  sleep  with.  No  other 
Woman's  milk  can  be  so  good  for  her  Child;  and  dry-nursing  I  look  upon 
to  be  the  most  unnatural  and  dangerous  method  of  all;  and,  according 
to  my  observation,  not  one  in  three  survives  it.  To  breed  a  Child  in  this 
artificial  manner,  requires  more  knowledge  of  Nature,  and  the  animal 
economy,  than  the  best  Nurse  was  ever  mistress  of,  as  well  as  more  care 
and  attention  than  is  generally  bestowed  on  Children :  the  skill  of  a  good 
Physician  would  be  necessary  to  manage  it  rightly. 

The  last  sentence  is  one  of  the  best  statements  of  the  case 
with  which  the  commentator  is  familiar,  and  it  might  be  used  as  a 
text  by  the  modern  crusader  in  the  cause  of  the  infant. 

Orders  should  be  given  these  Nurses  to  keep  the  Children  awake  by 
day,  as  long  as  they  are  disposed  to  be  so,  and  to  amuse  and  keep  them 
in  good  humour  all  they  can;  not  to  lull  and  rock  them  to  sleep,  or  to 
continue  their  sleep  too  long;  which  is  only  done  to  save  their  own  time 
and  trouble,  to  the  great  detriment  of  the  Childrens  health,  spirits,  and 
understanding.  With  regard  to  feeding  them,  as  it  is  not  likely  they 
should  have  milk  enough  to  support  two,  their  own,  and  the  Hospital- 
child;  it  is  best  they  should  begin  immediately  according  to  the  method 
I  have  recommended,  if  they  or  their  inspectors  can  be  persuaded  to 
think  it  right;  which,  however,  I  would  not  have  understood  too  strictly, 
but  it  might  sometimes  be  a  little  varied,  preserving  only  the  intention. 
I  would  advise,  however,  if  it  be  thought  proper,  now  and  then,  to  give 
them,  as  they  grow  up,  a  little  bread  and  butter;  that  the  butter  be 
perfectly  sweet  and  fresh,  and  allowed  but  in  very  small  quantity; 
otherwise  it  will  be  apt  to  turn  bitter  and  rancid  in  the  stomach,  and 
foul  all  the  juices  of  the  body.  A  Child  may  be  allowed  any  kind  of  mel- 


WILLIAM  CADOGAN  397 

low  fruit,  either  raw,  stewed,  or  baked;  roots  of  all  sorts,  and  all  the 
produce  of  the  kitchen-garden. 

The  modern  book  on  the  feeding  of  infants  has  gone  back  to 
the  early  custom  of  allowing  other  foods  than  milk  during  the 
first  year.  The  use  of  vegetables  and  fruits  during  this  period 
was  looked  upon  as  a  great  advance  by  those  advocating  it 
recently.  The  only  new  thing  was  the  cluttering  of  the  state- 
ments with  remarks  about  antiscorbutics  and  vitamines.  Science 
must  needs  peddle  with  the  names  of  things.  The  antiscorbutic 
idea  harks  back  as  far  as,  if  not  farther  than,  Jacques  Cartier, 
who  on  his  second  voyage  up  the  St.  Lawrence  cured  scurvy  in 
his  crew  with  a  decoction  of  the  bark  and  leaves  of  the  hemlock 
spruce.  One  wonders  why  the  name  Cartierites  was  not  used  in 
place  of  antiscorbutics. 

Cadogan  advises  meat  a  little  early  according  to  present-day 
uses  and  wisely  rules  against  sweets. 

As  soon  as  the  Children  have  any  teeth,  at  six  or  eight  months  they 
may  by  degrees  be  used  to  a  little  flesh-meat;  which  they  are  always 
very  fond  of,  much  more  so  at  first,  than  of  any  confectionary  or  pastry 
wares,  with  which  they  should  never  debauch  their  taste. 

One  cannot  be  sure  who  first  used  magnesia  in  pediatric 
practice,  but  surely  he  was  a  man  who  should  be  proclaimed  as  a 
benefactor.  Prior  to  its  use  the  testaceous  antacids  were  all 
more  or  less  constipating.  Of  its  use,  our  old  worthy  speaks  in 
highest  praise  and  were  our  manufacturing  chemists  a  more 
scholarly  lot  (some  indeed  are),  this  recommendation  of  his  had 
doubtless  been  printed  on  the  labels  of  the  proprietary  product. 

As  I  have  said,  that  the  first  and  general  cause  of  most  of  the  diseases 
of  infants  are  liable  to  is  the  acid  corruption  of  their  food;  it  may  not  be 
amiss  just  to  mention  an  easy  and  certain  remedy,  or  rather  preventative, 
if  given  timely,  at  the  first  appearance  of  predominating  acid;  which  is 
very  obvious  from  the  crude,  white,  or  green  stools,  gripes  and  purgings 
occasioned  by  it.  The  common  method  when  these  symptoms  appear,  is 
to  give  the  pearl-julep,  crab's-eye,  and  the  testaceous  powders;  which, 
though  they  do  absorb  the  acidities,  have  this  inconvenience  in  their 
effect,  that  they  are  apt  to  lodge  in  the  body,  and  bring  on  a  costiveness, 
very  detrimental  to  infants,  and  therefore  require  a  little  manna,  or 
some  gentle  purge,  to  be  given  frequently  to  carry  them  off.  In  stead  of 
these,  I  would  recommend  a  certain  fine  insipid  powder,  called  Magnesia 


398  PEDIATRICS  OF  THE  PAST 

alba,  which,  at  the  same  time  that  it  corrects  and  sweetens  all  sournesses, 
rather  more  effectually  than  the  testaceous  powders,  is  likewise  a  lenient 
purgative,  and  keep  the  body  gently  open.  This  is  the  only  alkaline  purge 
I  know  of,  and  which  our  dispensatories  have  long  wanted.  I  have  taken 
it  myself,  and  given  it  to  others  for  the  heart-burn,  and  find  it  to  be  the 
best  and  most  effectual  remedy  for  that  complaint.  It  may  be  given  to 
Children  from  one  to  two  drams  a  day,  a  little  at  a  time,  in  all  their  food, 
'till  the  acidities  be  quite  overcome,  and  the  concomitant  symptoms 
disappear  entirely.  I  have  often  given  it  with  good  and  great  effect,  even 
when  the  Children  have  been  far  gone  in  diseases  first  brought  on  by 
prevailing  acid. 

There  is  one  thing  more  which  I  forgot  to  mention  in  it's  proper 
place,  and  therefore  I  must  take  notice  of  it  here;  that  is,  the  degree 
of  exercise  proper  for  Children.  This  is  of  more  consequence  than  all  the 
rest;  for  without  it,  all  our  care  in  feeding  and  cloathing  will  not  succeed 
to  our  wishes :  but  when  by  due  degrees  a  Child  is  brought  to  bear  a  good 
deal  of  exercise  without  fatigue;  it  is  inconceivable  how  much  impro- 
priety and  absurdity  in  both  those  articles  it  will  endure  unhurt.  A  Child, 
therefore,  should  be  pushed  forwards,  and  taught  to  walk  as  soon  as 
possible.  A  healthy  Child  a  year  old  will  be  able  to  walk  alone.  This  we 
may  call  the  aera  of  their  deliverance;  for  this  great  difficulty  sur- 
mounted, they  generally  do  well,  by  getting  out  of  the  Nurse's  hands  to 
shift  for  themselves.  And  here  I  must  endeavour  to  correct  a  great  mis- 
take, which  is,  that  most  people  think  it  wrong  to  put  weakly  Children 
upon  their  legs,  especially  if  they  are  the  least  bent  or  crooked;  but 
whoever  will  venture  the  experiment  will  surely  find,  that  crooked  legs 
will  grow  in  time  strong  and  straight  by  frequent  walking,  while  disuse 
will  make  them  worse  and  worse  every  day.  As  they  grow  daily  more  and 
more  able,  let  their  walks  be  gradually  increased,  'till  they  can  walk  two 
miles  on  a  stretch  without  weariness;  which  they  will  be  very  well  able 
to  do  before  they  are  three  years  old,  if  they  are  accustomed  to  it  every 
day.  To  lead  them  such  a  walk  should  be  imposed  as  an  indispensable 
task  upon  their  maids,  for  to  them  it  will  be  the  highest  pleasure;  so  far 
from  a  burden  to  them,  that  if  they  perform  the  daily  duty,  they  will, 
from  the  impulse  of  their  own  active  vigour,  be  found  running,  leaping, 
and  playing,  all  day  long.  Thus,  a  dull,  heavy  Child  may  be  made 
playful  and  sprightly,  a  weakly  one  healthy  and  strong,  and  confirmed 
in  good  habits  and  perpetual  health. 

We  take  our  leave  of  Cadogan  with  regret  and  add  only  a 
little  anecdote  to  close  this  section. 

A  Lady  of  great  sway  among  her  acquaintance  told  me  not  long  ago* 
with  an  air  of  reproach,  that  she  had  nursed  her  Child  according  to  my 
book,  and  it  died.  I  asked,  if  she  had  suckled  it  herself?  No.  Had  it 


WILLIAM  CADOGAN  399 

sucked  any  other  woman?  It  was  dry-nursed.  Then,  Madam,  you 
cannot  impute  your  misfortune  to  my  advice,  for  you  have  taken  a 
method  quite  contrary  to  it,  in  the  most  capital  point.  Oh  but,  according 
to  my  direction,  it  had  never  worn  stockings.  Madam,  Children  may  die, 
though  they  do  or  do  not  wear  stockings. 


THE  FIRST  PEDIATRIC  ANTHOLOGY  IN  ENGLISH 

[1742] 

THE  Library  of  the  Surgeon-General  numbers  a  very  rare 
volume  among  its  thousands  of  rare  volumes,  an  item  which 
one  may  assume  with  a  reasonable  degree  of  certainty  to  be 
the  first  pediatric  anthology.  It  is  a  small  volume  of  some  two 
hundred  and  sixty  pages,  and  was  printed  for  A.  Millar,  over 
against  St.  Clement's  Church  in  the  Strand,  1742.  The  compiler  is 
unknown,  so  it  is  catalogued  "  Full  (A)  View  of  AH  the  Diseases 
Incident  to  Children, "  which  led  to  the  incorrect  assumption 
that  Dr.  A.  Full  had  been  a  pediatrist  and  a  certain  amount  of 
anticipatory  joy  at  having  discovered  a  hitherto  unknown  writer 
in  the  diseases  of  children  was  killed  by  finding  out  that  this 
was  just  a  little  unconscious  jest  on  the  part  of  the  indexer.  The 
book  contains  selections  from  Harris,  for  whom  the  unknown 
compiler  had  a  warm  regard.  It  also  contains  Boerhaave  on  the 
diseases  of  children,  Sylvius  on  thrush,  Willis  on  epilepsy,  Syden- 
ham on  smallpox  and  measles,  Andry  on  worms,  Burton  on 
chin-cough,  Glisson  on  rickets,  and  Wiseman  on  the  king's  evil. 

There  are  no  notes  or  biographical  details,  so  some  of  its 
value  is  lost,  but  it  shows  an  earnest  desire  to  preserve  some 
of  the  literary  monuments  of  the  medicine  of  the  past. 


400 


ROBERT  WHYTT 

[1714-1766] 

ROBERT  WHYTT,  professor  of  medicine  in  the  University  of 
Edinburgh  from  1 747  to  1 766,  is  one  of  the  men,  who,  famous 
L  in  their  own  age,  and  justly  so,  are  fast  disappearing  from  the 
encyclopedias  of  biography.  W.  Seller1  in  1862,  from  whose 
article  most  of  these  facts  are  gleaned,  stated  that  even  in  his 
time  Whytt's  name  had  been  omitted  from  some  of  the  collec- 
tions and  the  fact  that  his  name  does  not  appear  in  Hirsch's 
" Lexicon* '  is  sufficient  justification  for  including  some  bio- 
graphical data  about  a  man  who  left  one  of  the  most  remarkable 
clinical  monographs  ever  written.  In  1768  he  published  his 
treatise,  "Observations  on  the  Dropsy  in  the  Brain."  The  sub- 
ject was  not  a  new  one,  as  we  shall  see,  but  with  a  score  or  so  of 
cases  he  managed  to  observe  everything  of  clinical  value  that 
could  be  made  out,  unaided  by  the  instruments  of  modern  science. 
A  remarkable  feat,  and  truly  his  paper  is  a  model  in  brevity  and 
lucidity.  Read  it  carefully  and  be  convinced. 

And  who  was  Whytt?  A  Scotchman  born  in  17 14,  an  indus- 
trious student  who  received  his  a.  m.  at  the  age  of  sixteen.  The 
University  had  just  established  a  School  of  Medicine  and  in  1 730 
the  five  professors  were  recognized  by  the  Senatus  Academicus 
as  a  Medical  Faculty.  In  this  year,  Whytt  began  the  study  of 
medicine,  devoting  to  it  three  or  four  years,  much  of  which  was 
spent  on  anatomy  under  Monro. 

In  1734,  Whytt  went  to  London  to  walk  the  hospitals  as  a 
pupil  of  Cheselden,  thence  to  Paris,  to  the  clinics  at  "La  Charite" 
and  "Hotel  Dieu,"  where  he  met  Winslow,  after  which  he  went 
to  hear  the  aging  Boerhaave,  at  Leyden,  and  his  pupil,  Albinus. 
His  degree  was  taken  in  April,  1736,  at  Rheims,  a  university 
suppressed  during  the  first  French  revolution,  but  at  that  time 
much  frequented  for  the  purpose  of  taking  medical  degrees. 
Dr.  Osier  once  called  my  attention  to  a  quotation  from  the  diary 

l7>.  Roy.  Soc.  Edinb.,  1861-62,  xxm,  pp.  99-131. 

401 


OBSERVATIONS 

ON     T  H  K 

DROPSY    in    the    BRAIN, 

B  Y 

ROBERT  WHYTT,  m.  d. 

Late  PHYSICIAN  to   his   MAJESTY, 

Prefidcnt  of  the  Royal  College  of  Phyficians,  Profefibr  of 
Medicine  in  the  Univcrfity  of  Edinburgh,   and  F.R.  S. 

TO  WHICH  ARE  ADDED 

His   other    TREATISES    never  hitherto  publifhed 
by  thcmfelves. 

EDINBURGH: 

Pfinted     for      JOHN      BALFOUR, 
By  BALFOUR,  AULD,  &  SMELLIE. 

M.DCC,LXV)II. 

Title  page  of  Whytt's  "Observations  on  Dropsy  of  the  Brain." 


ROBERT  WHYTT  403 

of  "that  gossipy  parson-physician,"  Dr.  John  Ward,  which  throws 
some  light  on  the  question  of  why  degrees  were  taken  at  Rheims 
and  other  universities  rather  than  at  Leyden.  "Doctor's  degree 
at  Leyden  costs  sixteen  pounds  besides  the  feasting  of  the  Faculty; 
at  Angers  not  above  nine  pounds  and  feasting  not  necessary 
neither." 

The  following  year  (1737),  St.  Andrews  conferred  upon  Whytt 
the  degree  of  doctor  of  medicine;  he  was  admitted  as  a  licentiate, 
and  a  year  later,  as  a  member  of  the  Royal  College  of  Physicians 
of  Edinburgh.  Ten  years  after  receiving  his  doctorate,  he  was  com- 
missioned to  the  chair  of  the  Theory  of  Medicine,  and  in  1752, 
was  elected  a  fellow  of  the  Royal  Society  of  London.  In  1761, 
he  was  made  first  physician  to  the  King  of  Scotland;  it  is  said 
this  position  was  created  especially  for  him.  In  1763,  he  was 
elected  President  of  the  Royal  College  of  Physicians,  which 
position  he  held  to  his  death.  He  was  a  correspondent  of  Sir 
John  Pringle,  who  after  Whytt* s  death,  assisted  his  son  in  col- 
lecting and  editing  his  works.  Whytt  also  corresponded  with 
other  physicians.  Especial  mention  may  be  made  of  Dr.  Alex- 
ander Garden,  Charleston,  South  Carolina,  whose  name  is  per- 
petuated in  the  Gardenia,  the  garland  flower.  Whytt  gives  an 
account  of  a  new  plant  which  Garden  had  described  and  written 
him  about,  and  he  also  mentions  the  vermifuge  action  of  the 
Carolina  pink,  of  which  he  had  heard  from  another  Charleston 
physician,  Dr.  John  Lining.  These  papers  were  published  in  the 
Edinburgh  Essays,  Physical  and  Literary.  He  also  gives  an  account 
of  yellow  fever  at  Charleston,  which  he  had  received  from  Dr. 
Lining. 

Whytt  was  a  rather  prolific  writer.  His  works  not  only  ran 
through  more  than  one  edition,  but  some  were  translated  into 
French,  one  or  two  into  Norwegian,  and  a  German  edition  was 
published  after  his  death.  Space  prevents  an  account  of  how  he 
simplified  the  secret  cure  for  stone  for  which  Parliament  had 
granted  a  certain  Mrs.  Stephen  five  thousand  pounds.  His  paper, 
"On  the  Virtues  of  Lime- Water  in  the  Cure  of  Stone,"  was  a  great 
success  and  was  followed  in  1750  by  an  article  in  the  Edinburgh 
Essays,  Physical  and  Literary,  on  the  various  properties  of  lime- 
water.  A  year  later  his  work,  "On  the  Vital  and  Other  Involuntary 
Motions  of  Animals,"  attracted  widespread  attention.  Seller, 
in  his  "Address"  on  Whytt,  says  that  it  was  a  misapprehension 


404  PEDIATRICS  OF  THE  PAST 

of  certain  expressions  used  by  him  that  led  to  the  current  belief 
that  he  was  an  exponent  of  the  theory  of  Stahl.  Seller  also  thinks 
that  much  of  the  lack  of  interest  in  Whytt  is  due  to  the  sup- 
position that  the  glory  of  the  master  overshadowed  the  pupil. 
He  protests  against  the  idea  that  Whytt  was  a  follower  of  Stahl 
and  goes  into  his  explanations  at  considerable  length.  StahPs 
idea  was  that  "there  is  a  rational,  provident,  conscious  prin- 
ciple that  originates  and  directs  all  the  phenomena  of  living 
Nature."  From  the  earliest  times  this  idea  has  prevailed.  The 
ancients  supposed  the  presence  of  dryads  and  nymphs  and  the 
like,  to  explain  the  actions  of  the  world  organic  and  inorganic. 
Hence  arose  the  idea  of  a  world  soul,  of  the  animal  soul  and  of 
the  vegetable  soul  of  the  older  philosophers.  This  idea  of  a  soul 
producing  the  phenomena  of  animal  life  is  present  in  the  writ- 
ings of  Paracelsus  and  indeed  of  all  the  Medieval  and  Renaissance 
writers,  even  Harvey.  It  was  the  idea  of  Descartes  and  was  the 
essential  of  the  philosophy  of  Van  Helmont  and  of  Stahl. 
Seller  explains  Whytt's  position  as  follows: 

In  common  it  is  true  not  only  with  physiologists  of  the  Stahlian 
school,  but  with  those  of  all  preceding  schools  of  physiology  from  Hippoc- 
rates downward,  Whytt  traced  animal  movements  to  an  animal  or 
psyche;  but  he  differs  with  Stahl,  to  borrow  the  description  of  Haller, 
so  widely,  that  he  regarded  such  movements  as  being  the  immediate 
result  of  a  stimulus,  without  any  reason,  intention,  or  consciousness  on 
the  part  of  the  anima. 

Whytt  thought  that  voluntary  motions  were  produced  by 
the  immediate  action  and  energy  of  the  mind,  and  that  all  the 
voluntary  motions  of  animals  were  produced  in  this  way.  He 
held  that  Stahl  brought  ridicule  on  his  theories  by  extending  this 
idea  of  psychic  influence  too  far,  but  in  respect  to  human  psy- 
chology, Stahl  was  a  true  precursor  of  Freud.2  One  may  quote 
here  a  part  of  Whytt's  writing  which  gives  not  only  a  good  idea 
of  what  he  thought,  but  of  his  style  as  well. 

But  there  is  no  need  of  understanding  the  nature  of  the  soul,  or  the 
way  in  which  it  acts  upon  the  body,  in  order  to  know  that  the  vital 
motions  are  owing  to  it;  it  is  sufficient  if  we  know  from  experience  that 
it  feels,  is  ensued  with  sensation  and  has  the  power  of  moving  the  body. 
It  is  no  sufficient  objection  that  we  are  unconscious  of  the  mind  in  the 
vital  and  involuntary  movements;  for  some  of  the  voluntary  motions 

*  Neuburger. 


Robert  Whytt 

[1714-1766] 


ROBERT  WHYTT  405 

are  performed  while  we  are  insensible  of  the  power  of  the  will  being 
exerted  in  their  direction. 

Some,  indeed,  have  gone  so  far  as  to  deny  that  even  voluntary 
motions  are  owing  to  the  mind  as  their  proper  cause,  and  have  thought 
the  direction  of  the  voluntary  muscles,  in  order  to  perform  the  various 
motions  of  the  body,  to  be  an  office  which  its  faculties  are  not  equal  to. 
But  if  these  motions  be  not  owing  to  the  mind,  from  what  cause,  external 
or  internal,  do  they  proceed?  They  cannot  be  owing  to  the  body  alone; 
and  it  is  vain  to  attribute  them  to  any  law  which  it  may  be  pretended 
that  the  Deity  established,  since  a  law  can  produce  no  effect  of  itself; 
and  without  some  agent  to  execute,  it  is  only  a  mere  name  or  empty 
sound;  they  must  therefore  be  ascribed  to  the  immediate  agency  of  the 
Supreme  Being,  or  to  that  of  some  general  inferior  Nature  which  He  has 
constituted  for  this  purpose,  or  to  the  energy  of  a  particular  active 
principle  united  with  the  body.  The  first  two  propositions  are  possible, 
but  not  probable,  as  is  the  last;  whence  it  may  be  inferred,  that  not  only 
the  voluntary  motions,  of  which  we  are  immediately  conscious,  but  those 
also  which  we  do  not  advert  to,  proceed  from  that  sentient  and  intelli- 
gent principle  with  which  the  Creator  has  animated  our  bodies,  whose 
powers  and  operations,  it  must  be  owned,  are  in  many  instances  as  much 
above  our  knowledge,  as  is  the  nature  of  its  union  with  the  body,  or  the 
manner  of  their  reciprocal  action  upon  each  other. 

Many  of  Whytt's  ideas  as  expressed  in  this  work  are  strik- 
ingly near  what  is  taught  today.  His  idea  of  the  vital  functions 
of  the  body  was  that  they  are  carried  on  by  being  dependent  on 
an  influence  derived  from  the  nervous  system.  As  regards  the 
correlation  and  harmony  of  the  working  of  the  bodily  functions, 
his  ideas  were  evidently  correct.  His  ideas,  as  regards  the  invol- 
untary motions  that  are  not  vital,  are  the  foundation  of  our 
knowledge  of  the  subject  today,  and  he  furnished  the  largest 
generalization  which  has  been  formulated  as  regards  the  general 
activity  in  the  organic  world.  In  Whytt's  day  these  motions 
were  not  called  reflex,  but  he  has  given  us  most  admirable  accounts 
of  the  various  types  of  reflexes  without  naming  them  as  such,  and 
his  ideas  were  the  starting  points  for  later  physiologists. 

Another  point  that  Whytt  brought  out,  but  which  he  could 
not  at  that  time  demonstrate,  was  that  the  nerve  fiber  runs 
intact  from  one  end  to  the  other,  and  the  identity  of  the  separate 
nerve  fibrils. 

Whytt  may  be  regarded  as  the  great  exponent  of  reflex  action. 
Most  authors  previous  to  him  had  hinted  at  it  or  described  it 


4o6  PEDIATRICS  OF  THE  PAST 

more  or  less  vaguely,  but  he  came  very  near  the  modern  idea  of 
the  spinal  reflex. 

In  1764,  Whytt  published  a  book  entitled  "On  Nervous, 
Hypochondriacal,  or  Hysterical  Diseases,  to  which  are  prefixed 
some  remarks  on  the  Sympathy  of  the  Nerves."  Much  of  the 
book  is  an  elaboration  of  his  previous  essay  on  "Animal  Motions." 
This  book  is  a  mine  of  observations  and  comments  on  what  we 
should  nowadays  call  reflex  action  of  various  kinds. 

His  collected  works  were  published  in  1768  by  his  son  and 
Sir  John  Pringle.  Among  the  detached  papers  the  following  are  of 
especial  interest: 

"On  the  difference  between  Respiration  and  the  Motion  of  the  Heart 

on  Sleeping  and  Waking  Persons." 

"On  the  Cure  of  a  Fractured  Tendo  Achilles." 

"On  the  Use  of  Bark  in  Dysentery,  and  a  Hoarseness  after  Measles.'* 

"Observations  on  the  Anomalous  and  the  True  Gout." 

"Of  an  Epidemic  Distemper  at  Edinburgh  and  Southern  Parts  of 

Scotland  in  1758." 

"On  the  Use  of  Sublimate  in  the  Cure  of  Phagedenic  Ulcers." 
"Account  of  an  Earthquake  felt  at  Glasgow;  also  of  a  shower  of 

Dust  falling  on  a  Ship  between  Shetland  and  Iceland." 

"On  the  Remarkable  Effects  of  Blisters  in  lessening  the  Quickness 

of  the  Pulse  in  Cough,  attended  with  Infarction  of  the  Lungs  and  Fever." 

The  following  characterization  of  the  man  by  Seller  is  worth 
quoting: 

In  short,  Whytt,  though  of  an  ardent  temper,  really  was  a  man  of 
well  balanced  feelings,  earnest  after  truth,  not  unsolicitous  of  fame, 
while  all  the  sentiments  he  expresses  indicate  a  benevolent  turn  of  mind, 
full  of  love  to  mankind,  and  a  determination,  at  any  cost  to  himself, 
to  fulfill  the  duties  of  his  station. 

Acute  internal  hydrocephalus  was  no  new  thing  when  Whytt 
came  to  consider  it,  but  when  he  left  it,  he  had  set  up  a  monu- 
ment, a  sort  of  milestone,  as  it  were,  in  the  history  of  our  knowl- 
edge of  the  disease.  We  may  correctly  speak  of  the  history  of 
tuberculous  meningitis  as  being  divided  into  two  parts;  first, 
from  the  earliest  times  to  Whytt's  monograph  in  1768,  and 
secondly,  from  then  on.  It  may  not  be  out  of  place  to  give  some 
few,  by  no  means  all,  or  anything  approaching  all  of  the  opinions 
and  facts  about  it. 


ROBERT  WHYTT  407 

Until  Whytt  the  disease  was  practically  unknown.  Allusions 
had  been  made  to  it,  cases  had  been  reported,  autopsies  made 
and  even  a  good  clinical  description  had  been  buried  under  an 
unfortunate  name  to  be  resurrected  years  later. 

The  earlier  writers  contain  numerous  references  which  have 
been  thought  to  indicate  some  knowledge  of  the  disease  and  its 
symptoms.  For  the  most  part  the  early  writers  contented  them- 
selves with  descriptions  of  "phrenitis,"  which  covered  practically 
all  of  the  affections  in  which  there  was  much  mental  disturbance. 

Hippocrates  is  said  to  have  enumerated  the  signs  of  water  on 
the  brain,  or  as  Whytt  would  have  it,  upon  the  brain.  He  also 
suggested  the  treatment  of  opening  the  top  part  of  the  cranium 
to  let  it  out.  Aetius  and  Paul  of  Aegina  mention  a  collection  of 
water  between  the  skull  and  the  membranes  of  the  brain.  Celsus 
mentions  only  briefly  external  hydrocephalus,  which  was  the  term 
applied  by  early  writers  to  edema  of  the  scalp.  Hieronymus 
Mercurialis,  in  the  sixteenth  century,  mentioned  that  a  collec- 
tion of  water  in  the  ventricles  of  the  brain  was  a  possibility,  but 
states  that  in  such  a  case  apoplexy  would  be  the  result.  Galen 
knew  some  form  of  meningitis,  but  apparently  not  that  accom- 
panied with  dropsy,  for  he  notes,  "Phrenitis  depends  upon  an 
inflammation  of  the  brain  and  its  envelopes." 

The  most  remarkable  mention  is  perhaps  that  of  Willis,  in 
1682,  where  he  states  in  his  "De  Anima  Brutorum": 

Sometimes  headaches,  fatal  and  incurable,  follow  abscesses  and  swell- 
ings of  the  envelopes  of  the  brain,  as  well  as  placques  and  tubercles  of 
these  membranes.  (Nee  minus  a  pblegmone  et  abcessu  quam  bujas  modi 
meningitis  et  tuberculis,  cepbaligiae  letbales  et  incurabiles  oriuntur.) 

In  his  section  on  "Headache"  he  has  the  following  sentence: 
Yea,  I  have  known  inflammation,  Imposthumes,  whelks,  scirrhus 
Tumors  growing  to  the  Meninges,  with  the  Skull,  and  other  Diseases  of 
an  evil  conformation,  excited  in  the  Membranes  of  the  Brain;  by  which 
at  first  for  a  long  time,  frequent  headaches,  and  most  cruel,  and  then 
afterwards  a  sleepy  and  deadly  distemper  hath  been  induced;  the  cause 
of  the  Disease  not  detected,  but  after  Death  by  the  Anatomy;  and  indeed 
it  is  to  be  suspected  that  inveterate  and  pertinacious  pains  in  the  Head, 
which  return,  and  dayly  become  more  tormentive,  in  spight  of  all 
Remedies  depend  upon  some  such  invincible  Cause. 

Boerhaave  mentions  such  a  disorder  as  one  species  of  hydro- 
cephalus. Duverney,  jeune,  in  1704,  mentions  a  girl  of  four  who 


4o8  PEDIATRICS  OF  THE  PAST 

died  in  fifteen  days,  and  at  the  autopsy  water  was  found  in  the 
ventricles  of  the  brain.  The  mesenteric  glands  were  also  diseased. 
His  description  is  quite  apt  and  his  title  was  "Observation  on  a 
Dropsy  of  the  Brain. " 

Petit,  in  1718,  in  the  "Memoirs  of  the  Academy  of  Sciences," 
mentions  that  in  bodies  which  he  had  opened  he  never  found  water 
anywhere  except  in  the  ventricles  and  concludes  that  other 
varieties  are  very  rare.  He  gives  among  the  symptoms  slight 
convulsions  of  the  mouth  and  eyelids,  biting  of  the  lips,  grinding 
of  the  teeth,  picking  of  the  nose  as  in  worms,  drowsiness,  that 
patients  grow  languid,  feeble,  sad  and  pale,  that  the  sutures  of 
the  skull  open,  that  the  forehead  rises,  and  the  eyes  seem  to 
protrude  and  that  the  head  swells  as  if  to  burst.  He  evidently 
got  the  acute  and  the  chronic  forms  of  hydrocephalus  confused. 

Andre  de  Saint  Clair,  as  the  French  call  him,  whom  we  know 
as  Sinclair,  one  of  the  first  of  the  Edinburgh  professors,  pub- 
lished, in  1732,  a  treatise  concerning  the  diagnosis  and  treatment 
of  effusions  in  the  brain  and  made  out  the  intermissions  and 
remissions  which  gave  it  some  resemblance  to  intermittent  fever. 
Paisley,  of  Glasgow,  in  1733  published  a  case  of  hydrocephalus 
with  remarkable  symptoms. 

Donald  Monro  enumerated  the  different  kinds  of  hydro- 
cephalus, but  he  did  not  give  any  methods  by  which  they  could 
be  distinguished.  Morgagni,  in  1761,  mentions  autopsies  where 
there  were  lesions  in  the  brain,  serosities,  as  he  called  them. 

Sauvages,  in  1763,  published  in  his  "Nosologic  Methodique"3 
an  article  which  he  entitled  "Eclampsia  ab  hydrocephalo." 
Owing  to  the  name  eclampsia  it  was  very  successfully  buried 
and  only  found  years  later,  one  does  not  know  exactly  when,  but 
Bricheteau  (1825)  gives  the  following  extract: 

Eclampsia  depending  upon  hydrocephalus,  commonly  called  water  in 
the  brain,  is  a  very  frequent  disease  which  carries  off  a  considerable 
number  of  our  children  even  in  the  families  of  the  most  distinguished 
rank.  It  would  be  very  important  if  one  could  foretell  it,  for  once  existing 
one  can  hardly  remedy  it.  It  attacks  children  of  three,  four  or  five  years, 
principally  those  who  are  affected  with  scrofula,  with  enlargements  of 
the  mesenteric  glands,  and  whose  parents  have  had  syphilis.  It  begins  by 
lack  of  appetite;  the  children  lose  their  taste  for  everything,  even  their 
toys;  they  are  pale,  sad,  capricious  and  of  a  bad  humour;  their  pulse  is 
3  Tome  ii,  part  2. 


ROBERT  WHYTT  409 

small,  languishing.  At  intervals  the  face  becomes  red  as  in  exacerbations 
of  acute  diseases.  To  this  there  is  added  feebleness,  a  sort  of  languor;  the 
head  becomes  very  heavy  and  totters  upon  the  shoulders;  the  mouth 
undergoes  sudden  distortion;  the  eyes  become  fixed  and  appear  covered 
with  a  sort  of  cloud;  the  hands  and  some  parts  of  the  face  are  agitated 
with  convulsive  movements;  the  intellectual  faculties  become  obscured, 
the  patients  are  drowsy,  and  as  if  stupid  or  dull;  the  pulse  becomes 
feeble,  frequent,  unequal,  and  death  takes  place  in  the  space  of  several 
days.  On  opening  the  body  one  finds  a  considerable  effusion  of  serous 
fluid  in  the  ventricles  of  the  brain. 

This  is  a  good  description,  but  it  cannot  be  compared  with 
the  classic  description  given  by  Robert  Whytt  in  1768.  Whytt's 
account  consists  of  forty-eight  octavo  pages  in  which  he  gives  a 
short  historical  resume  of  the  disease,  which  is  not  reprinted  here, 
and  states  that  no  author  had  given  any  signs  by  which  it  could 
be  distinguished.  He  evidently  did  not  know  of  the  works  of 
Sauvages. 

Whytt's  study  was  based  on  twenty  cases.  The  symptoms  come 
on  four,  five  or  even  six  weeks  before  death.  He  divides  the  dis- 
ease into  three  stages,  according  to  the  condition  of  the  pulse: 
the  first  stage  when  there  is  a  quick  pulse,  the  second  when  the 
pulse  is  slow,  and  the  last  when  the  pulse  again  becomes  rapid. 
For  further  details,  the  reader  is  referred  to  the  original  or  to  the 
following  reprint  of  Whytt's  monograph. 

Whytt's  work  gave  a  great  impetus  to  the  study  of  the  condi- 
tion, and  his  publication  was  followed  by  a  large  number  of 
contributions.  Among  these  may  be  mentioned  that  of  Quin  in 
1790.  He  states  that  in  some  few  cases  there  has  been  reason  to 
suspect  the  existence  of  a  scrofulous  taint.  He  noted,  too,  the  red 
spots  or  blotches.  He  pointed  out  that  the  dropsy  was  not  the 
main  feature  of  the  disease,  but  that  it  originated  in  a  morbid 
accumulation  of  blood  in  the  vessels  of  the  brain  which  sometimes 
elevated  to  a  certain  degree  of  inflammation;  this  often,  but  not 
always,  produces  an  effusion  before  death. 

Edward  Ford  thought  that  acute  hydrocephalus  was  due  to 
either  an  inflammation  of  the  pia  or  scirrhus  induration  (tuber- 
culosis) of  the  brain  and  cerebellum. 

In  America,  Benjamin  Rush,  in  1793,  published  an  account  of 
the  disease.  Many  others  wrote  about  the  disease  without  adding 


4io  PEDIATRICS  OF  THE  PAST 

anything  essential  to  it.  Fothergill,  1771,  in  England;  Ludwig, 
1774,  in  Germany;  and  Odier,  1779,  in  Geneva,  may  be  mentioned. 
Bichat  (1802),  had  he  not  died  so  soon,  would  have  probably 
unraveled  the  mystery  of  the  causation.  Listen  to  his  descrip- 
tion of  the  lesions : 

That  the  tissues  belonging  to  the  brain,  by  the  arachnoid,  to  the 
lungs  by  the  pleura,  to  the  abdominal  viscera  by  the  peritoneum,  it 
matters  not  which,  may  inflame  all  over  in  the  same  manner.  Either 
the  hydropsy  comes  on  uniformly  or  it  is  subject  to  a  species  of  eruption 
miliary-Iike  and  whitish,  which  has  not  been  mentioned,  I  believe,  and 
which  nevertheless  merits  great  consideration. 

References  to  the  later  contributions  need  not  be  given, 
but  one  may  turn  at  once  to  the  original  text,  which  needs  little 
or  no  comment,  and  find  as  perfect  a  piece  of  clinical  observation 
and  reporting  as  exists.  Nothing  essential  has  been  added  to 
the  clinical  history  since  Whytt  unless  it  be  through  the  use  of 
instruments  or  methods  not  available  in  his  time. 

OBSERVATIONS 

ON  THE 

DROPSY  in  the  BRAIN, 

BY 

ROBERT  WHYTT,  M.  D. 

Late  PHYSICIAN  to  his  MAJESTY, 

President  of  the  Royal  College  of  Physicians,  Professor  of  Medicine 

in  the  University  of  Edinburgh,  and  F.  R.  S. 

TO  WHICH  ARE  ADDED 

His  other  TREATISES  never  hitherto  published 

by  themselves. 

EDINBURGH: 

Printed  for  JOHN  BALFOUR, 

By  BALFOUR,  Auld,  &  SMELLIE. 

M,DCQLXVIII. 

OBSERVATIONS 
ON  THE 
Most  frequent  Species  of  HYDROCEPHA- 
LUS INTERNUS, 
VIZ, 
The  DROPSY  of  the  VENTRICLES 
of  the  BRAIN. 


ROBERT  WHYTT  411 

The  hydrocephalus,  or  dropsy  of  the  head,  is  either  external  or 
internal.  The  former  has  its  seat  in  the  cellular  substance,  between  the 
skin  and  the  pericranium,  or  between  this  membrane  and  the  skull. 
In  the  internal  hydrocephalus,  the  water  is  sometimes  collected  between 
the  cranium  and  dura  mater,  or  between  this  last  and  the  pia  mater; 
but  most  commonly  is  found  in  the  ventricles  of  the  brain,  immediately 
below  the  corpus  callosum:  And  this  is  not  only  the  most  frequent  and 
fatal  species  of  the  hydrocephalus,  but  also  that  with  which  medical 
writers  seem  to  have  been  least  acquainted. 

Dr.  Donald  Monro,  in  his  treatise  of  the  dropsy,  has  well  enumerated 
the  several  kinds  of  the  hydrocephalus:  But  by  the  symptoms  he  men- 
tions, of  the  internal  kind,  we  shall  be  hardly  able  to  distinguish  it  from 
several  other  disorders  of  the  brain,  as  he  himself  has  very  justly 
remarked. 

It,  may  seem  strange,  that  a  dropsy  of  the  ventricles  of  the  brain, 
which  in  our  days  so  frequently  occurs,  should  have  been  altogether 
unknown  to  the  ancients,  and  so  little  attended  to  by  most  of  the  moderns. 
The  reason  may  be,  that  those  patients  who  were  carried  off  by  this 
disease  have  been  generally  supposed  to  die  of  a  fever  ending  in  a  coma; 
and  in  such  cases  the  head  is  seldom  opened. 

Altho'  a  dropsy  of  the  ventricles  of  the  brain  does  very  rarely  occasion 
any  opening  of  the  sutures,  or  swelling  of  the  head  (Vesalius  gives  an 
account  of  a  child  of  two  years  old,  whose  head  was  greatly  enlarged,  and 
in  the  ventricles  of  whose  brain  he  found  nine  pounds  of  water:  But 
this  is  an  extraordinary  case;  and  it  is  probable  the  water  began  to  be 
collected  soon  after  the  child's  birth,  and  before  the  sutures  of  the  skull 
could  offer  any  considerable  resistance  to  its  pressure.  I  shall  only  add 
here,  that  I  have  not  only  never  observed  any  increase  of  the  size  of  the 
head  in  the  species  of  hydrocephalus  of  which  I  now  treat,  but  that  it  is 
an  error,  though  a  common  one,  to  imagine,  that  those  children  who  have 
big  heads  are  most  liable  to  this  disease;  for  of  all  those  whom  I  have 
attended,  few  or  none  were  remarkable  for  the  largeness  of  their  head, 
but  several  had  been  very  sprightly,  and  of  a  delicate  make.) ;  yet  in 
most  cases  it  may  be  easily  distinguished  from  every  other  disorder, 
by  the  following  symptoms,  which  with  the  greatest  care  I  have  collected, 
in  attending  about  twenty  patients  in  this  disease. 

an  account  of  the  symptoms  in  the  dropsy  of  the 

ventricles  of  the  brain 

First  Stage 

Children  who  have  water  in  the  ventricles  of  the  brain  begin  to  have 
many  of  the  following  symptoms,  four,  five,  or  six  weeks,  and  in  some 
cases  much  longer,  before  their  death. 


4i2  PEDIATRICS  OF  THE  PAST 

At  first  they  lose  their  appetite  and  spirits;  they  look  pale,  and  fall 
away  in  flesh;  they  have  always  a  quick  pulse,  and  some  degree  of  fever. 
In  some  cases  I  have  seen  a  hydrocephalus  attended  with  a  considerable 
degree  of  fever,  which  had  frequent  remissions,  but  without  any 
order  or  regularity:  In  other  cases  the  paroxysms  came  on  pretty  regu- 
larly in  the  evening,  and  then  the  disease  was  taken  for  a  slow  irregular 
nervous  fever,  or  for  one  occasioned  by  worms.  At  this  time,  in  children 
of  five  years  and  upwards,  I  have  found  the  pulse  at  a  hundred  and  ten, 
in  others  at  a  hundred  and  twenty,  and  in  a  few  cases  at  a  hundred  and 
thirty,  or  even  at  a  hundred  and  forty  strokes  in  a  minute;  but  rarely 
ever  so  full  as  to  indicate  bleeding. 

In  others  the  quickness  of  the  pulse  and  heat  of  the  skin  were  not  so 
considerable;  but  I  do  not  remember  to  have  seen  any  patient  who  had 
not  some  degree  of  fever  in  this,  which  I  call  the  first  stage  of  the  disease. 

While  the  feverishness  continues  or  increases,  they  lose  their  appetite 
more  and  more;  their  tongue  is  often  white,  sometimes  it  is  remarkably 
clean,  and  towards  the  end  of  the  disease  acquires  an  aphthous  redness. 
They  are  thirsty,  and  frequently  vomit  once  or  twice  in  a  day,  or  once 
in  two  days.  They  complain  of  a  pain  in  the  crown  of  their  head,  or  in 
the  forehead  above  their  eyes.  They  are  commonly  costive,  tho*  some- 
times they  have  returns  of  a  looseness.  When  bound,  they  are  not  easily 
moved  by  a  purge;  sometimes  they  are  troubled  with  gripes.  Their 
spirits  being  low,  they  incline  mostly  to  lie  in  bed,  altho'  they  are  often 
more  disposed  to  watching  than  to  sleep.  They  cannot  easily  bear  the 
light,  and  complain  when  a  candle  is  brought  before  their  eyes.  They  are 
observed  to  pick  their  nose,  and  in  their  sleep  to  grind  with  their  teeth, 
as  in  the  case  of  worms. 

These  are  the  symptoms  of  the  first  stage,  during  which  it  is  very 
hard  to  distinguish  this  dropsy  of  the  brain  from  a  slow  irregular  fever 
occasioned  by  worms,  by  some  other  disorder  in  the  bowels,  or  by  some 
other  cause.  In  the  second  stage,  the  symptoms  enable  us,  with  some 
certainty,  to  discover  the  nature  of  the  ailment.  But  before  I  proceed 
to  enumerate  them,  I  shall  just  observe,  that  I  never  had  but  two  patients 
who  had  not  the  vomiting  during  either  the  first  or  second  stage. 
One  of  these  was  a  girl  of  eight  years  of  age,  who,  tho'  she  had  an  aver- 
sion to  food,  yet  never  threw  it  up  but  once,  and  that  was  on  the  third 
day  before  her  death;  nor  did  she  ever  complain  of  a  headach  till  twelve 
or  fourteen  days  before  she  died;  whereas  this  last  symptom,  for  the 
most  part,  begins  three  or  four  weeks,  and  in  some  cases  several  months, 
before  the  end  of  the  disease:  She  also  could  bear  the  light  better  than 
any  I  have  seen.  The  other,  who  had  no  vomiting,  was  a  boy  of  eleven 
years;  he  had  little  headach,  altho'  he  lay  much  in  bed,  and  did  not 
like  to  be  moved.  But  in  general,  the  vomiting  once  or  twice  a-day,  or 


ROBERT  WHYTT  413 

once  in  two  or  three  days,  the  headach  (The  headach  not  only  in  this, 
but  the  succeeding  stages,  is  in  some  moderate,  in  others  severe;  in  which 
last  case,  it  is  always  easiest  in  the  morning  and  worst  at  night;  and 
these  patients  have  commonly  a  great  aversion  to  food.),  and  the  aver- 
sion to  light,  are  the  symptoms  which  in  the  first  stage  of  this  kind  of 
hydrocephalus  characterize  it  most. 

Symptoms  of  the  Second  Stage 

I  date  the  beginning  of  the  second  stage  from  the  time  the  pulse, 
from  being  quick  but  regular,  becomes  slow  and  irregular.  This  some- 
times happens  about  three  weeks,  often  a  fortnight  or  less,  before  the 
death  of  the  patient. 

In  this  stage  the  pulse  is  commonly  not  only  much  slower  than  it 
was  before,  but  often  more  so  than  in  health.  In  a  girl  of  thirteen,  the 
pulse,  which  for  a  fortnight  beat  above  a  hundred  times  in  a  minute, 
about  nine  days  before  she  died,  fell  to  eighty-four,  next  day  to  seventy, 
and  the  day  after  to  sixty,  becoming  always  more  irregular  the  slower  it 
was.  In  a  youth  of  sixteen  the  pulse,  which  for  several  weeks  had  been 
feverish,  on  the  fifteenth  day  before  his  death,  beat  only  sixty-eight  in  a 
minute;  two  days  after,  it  fell  under  sixty,  and  once  to  fifty. 

A  boy  of  nine  years  of  age,  fifteen  days  before  he  died,  had  a  pulse 
from  seventy  to  seventy-five  in  a  minute,  and  irregular.  In  another  of 
four  years,  the  pulse  fell  to  eighty-eight  on  the  ninth  day  before  his  end. 
In  a  girl  of  seven  years  old,  on  the  fifteenth  or  sixteenth  day  before  her 
death,  the  pulse  beat  a  hundred  and  fifty  times  in  a  minute;  next  day,  it 
became  slower  than  natural  and  irregular;  for  five  or  six  days  after  this, 
it  was  from  eighty  to  eighty-six  in  a  minute. 

In  two  other  children,  who  were  less  feverish  in  this  stage,  the  pulse 
from  a  hundred  fell  below  eighty.  I  have  never  seen  a  patient  with  water 
in  the  ventricles  of  the  brain,  whose  pulse  did  not  come  down  to  its 
natural  state,  or  very  near  it,  except  one.  This  was  a  girl  of  about  seven, 
whose  pulse,  after  being  for  several  weeks  about  a  hundred  and  thirty  in 
the  forenoon,  and  a  hundred  and  forty  in  the  evening,  a  fortnight  before 
her  death,  fell  two  or  three  strokes  under  a  hundred;  yet  neither  her 
heat  nor  thirst,  nor  other  complaints  abated,  altho'  her  pulse  had  fallen 
above  thirty  in  a  minute. 

In  this  distemper  it  is  observable,  that  when  the  pulse  is  nearly  as 
slow,  or  slower  than  natural,  it  is  always  irregular  or  unequal,  both  as  to 
the  strength  and  the  interval  of  the  strokes.  When  it  grows  quicker,  the 
irregularity  lessens;  and  when  it  becomes  very  quick,  it  is  then  most 
equal  and  regular.  Farther,  it  deserves  notice,  that,  altho*  in  the  second 
stage  the  pulse  becomes  much  slower  than  it  was  before,  the  heat  of  the 
skin  continues  much  the  same,  and  sometimes  seems  rather  to  increase. 


4i4  PEDIATRICS  OF  THE  PAST 

I  have  insisted  the  longer  on  the  state  of  the  pulse  in  this  period,  as 
from  thence  we  can  learn  the  surest  diagnostic. 

During  the  second  stage,  most  of  the  symptoms  mentioned  in  the 
first  continue.  The  sick  are  then  unable  to  sit  up,  tho*  generally  they 
sleep  little,  till  towards  the  end  of  this  period,  when  they  begin  to  grow 
drowsy.  They  moan  heavily,  yet  cannot  tell  what  ails  them.  Their  eyes 
are  often  turned  towards  their  nose,  or  they  squint  outwards,  and  some- 
times they  complain  of  seeing  objects  double.  Some,  towards  the  end  of 
this  stage,  grow  delirious,  and  cry  out  in  a  wild  manner,  as  if  they  were 
much  frightened:  About  this  time  also,  or  later,  they  frequently  void 
either  real  worms,  or  some  substance  like  worms  in  a  dissolved  state;  yet 
this  discharge  gives  no  relief  to  the  patient,  and  onIydheIps  to  deceive  the 
less  experienced  practitioner  with  regard  to  the  nature  of  the  disease. 

The  urine  in  this,  as  well  as  in  the  other  stages,  varies;  it  has  often  a 
large  sediment,  sometimes  none  at  all;  but  most  commonly  it  deposites 
one  of  a  light  consistence  and  a  white  colour.  In  several  I  have  observed 
the  urine  have  a  large  furfuraceous  sediment,  till  within  a  few  days  of 
their  death,  when  it  had  no  separation. 

The  breath  has  now,  but  especially  in  the  last  stage,  such  a  sickish  and 
offensive  smell,  as  I  do  not  remember  to  have  observed  in  any  other 
distemper.  During  the  second  as  well  as  the  first  stage,  the  patients  are 
often,  for  some  days,  or  parts  of  days,  much  easier  than  at  other  times. 


Symptoms  of  the  Third  Stage 

When  the  pulse  (which  for  some  time  was  nearly  as  slow  or  slower 
than  in  a  healthful  state)  rises  again  to  a  feverish  quickness,  and  becomes 
regular,  the  third  and  last  stage  may  be  said  to  begin. 

This  change  in  the  pulse  is  observed  five,  six,  or  seven  days  before 
death.  In  two  patients  only  the  pulse  did  not  become  more  frequent  till 
two  days  before  they  died;  and  in  two  others  it  began  to  grow  quicker  nine 
or  ten  days  before  that  event. 

As  the  time  of  this  change  in  the  pulse  is  different  in  different  patients, 
so  is  the  degree  of  its  quickness.  In  some  it  rises  gradually  from  below 
seventy,  eighty,  or  ninety  in  a  minute,  to  a  hundred  and  twenty,  a 
hundred  and  forty,  a  hundred  and  seventy,  and  sometimes  above  two 
hundred,  before  they  expire.  In  others  the  pulse  gets  up  more  suddenly, 
in  one  day  perhaps  from  a  hundred  to  a  hundred  and  fifty.  In  the  last 
stage,  after  the  pulse  grows  quicker,  it  does  not  keep  constantly  to  the 
same  measure,  but  will  be  often  a  good  deal  slower  for  part  of  a  day, 
and  quicker  all  the  rest.  The  pulse  beats  generally  faster  on  the  day 
they  die  than  at  any  other  time  before.  In  one  of  those  whom  I  attended, 
it  beat  above  two  hundred  and  ten  times  in  a  minute.  I  never  knew 


ROBERT  WHYTT  415 

any  go  off  in  this  disease  whose  pulse  did  not  rise  to  near  a  hundred  and 
thirty  strokes  in  that  time. 

In  the  third  stage,  the  patient,  who  before  was  little  disposed  to 
sleep,  becomes  then  drowsy  and  comatose.  When  roused,  he  utters 
only  a  few  incoherent  words,  and  appears  to  be  insensible.  The  beginning 
of  the  coma  is  uncertain ;  it  is  often  about  the  end  of  the  second  stage 
before  the  pulse  grows  quicker  for  the  second  time;  but  in  a  few  cases 
I  have  known  this  quickness  of  the  pulse  come  on  before  the  patients 
become  comatose. 

Frequently  one  eye-lid  loses  its  motion,  and  afterwards  the  other 
becomes  also  paralytic.  About  this  time,  or  rather  sooner,  the  pupil 
of  one  or  both  eyes  ceases  to  contract,  and  remains  dilated  in  the  greatest 
light.  But  the  time  of  this  symptom  varies  much:  In  some  it  happens 
five,  six,  or  seven  days,  in  others  only  two  or  three  days,  before  they  die. 
Three  or  four  days  before  the  death  of  a  boy  of  five  years  old,  I  was  sur- 
prised to  find  the  pupils,  which  had  been  much  dilated  before,  no  larger 
than  natural.  At  first  I  flattered  myself,  that  the  distemper  had  taken 
some  favourable  turn;  but  was  soon  undeceived;  for,  upon  giving  the 
child  a  spoonful  of  weak  cinnamon  water,  with  some  drops  of  spiritus 
volatilis  oleosus,  the  pupils  became  as  wide  as  they  had  been  the  day 
before.  In  less  than  half  an  hour  after,  they  contracted  again;  but 
immediately  dilated  upon  holding  some  spirit  of  sal.  ammoniacus  to 
his  nose.  I  have  since  observed  the  same  interchanges  in  the  pupils 
of  a  boy  four  years  old,  on  the  third  day  before  he  died.  In  this  case  the 
pupils  not  only  were  enlarged,  by  giving  him  a  spoonful  of  wine,  or  holding 
volatile  spirits  to  his  nose,  but  also  by  so  small  a  stimulus  as  my  lifting 
up  his  eye-lids,  which  had  lost  all  their  motion,  and  had  fallen  so  far 
down  as  to  cover  near  the  half  of  the  eye.  Before  they  are  seized  with 
the  coma,  they  sometimes  complain  of  seeing  strange  and  frightful  objects. 
A  day  or  two  before  death,  the  tunica  conjunctiva  of  one  or  both  eyes 
frequently  becomes  inflamed;  but  they  generally  continue  to  hear  for 
some  days  after  they  are  blind. 

In  this  stage,  the  patients  are  sometimes  observed  to  be  constantly 
raising  one  of  their  hands  to  their  head;  and  are  generally  troubled  with 
convulsions  of  the  muscles  of  the  arms,  legs,  or  face,  as  well  as  with  a 
subsultus  tcndinum.  In  a  girl  of  thirteen,  the  day  before  she  died,  the 
hands  were  strongly  bent  inwards  by  a  fixed  spasm  of  their  muscles. 
A  youth  of  sixteen,  who  when  in  health  had  been  liable  to  spasms, 
about  the  end  of  the  second  stage  began  to  be  affected  once  or  twice 
a-day  with  a  cramp  in  one  of  his  arms,  which  ascended  to  his  throat, 
and  often  prevented  his  speaking  for  some  minutes.  One  of  the  cheeks 
will  twice  or  thrice  in  a  day  grow  hot  and  red,  while  the  other,  with 
the  lips,  remains  pale  and  cold.  These  flushings  generally  appear  two, 


4i6  PEDIATRICS  OF  THE  PAST 

three,  or  four  days  before  death.  In  a  boy  of  five  years  old,  one  side  of 
both  his  arms  became  frequently  red,  while  the  other  side  never  changed 
its  colour.  After  death,  the  arms  and  breasts  have  been  seen  of  a  deep 
purple  colour. 

I  had  one  patient  who,  four  days  before  he  died,  bled  once  and  again 
at  the  nose. 

Those  who  have  been  costive  before,  often  become  loose  in  the 
third  stage,  and  complain  of  gripes.  A  day  or  two  before  death,  the 
patient  either  swallows  with  difficulty,  or  not  at  all.  Lastly,  the  respira- 
tion grows  more  frequent  and  laborious;  and  in  some  there  is  a  con- 
siderable pause  after  every  expiration.  This  kind  of  breathing  I  have 
also  observed  in  those  who  have  died  of  an  apoplexy,  arising  from  a 
suppression  of  urine. 

Upon  opening  the  heads  of  ten  of  those  patients  from  whom  I  have 
collected  the  symptoms  above  mentioned,  I  found  in  all  of  them  a  clear 
thin  fluid  in  the  anterior  ventricles  of  the  brain,  immediately  below  the 
corpus  callosum.  There  was  frequently  the  same  kind  of  liquor  in  the 
third  and  fourth  ventricles ;  but  whether  this  is  always  the  case,  I  cannot 
say,  as  I  had  not  attended  sufficiently  to  this  circumstance.  I  never  met 
with  water  between  the  dura  mater  and  the  brain,  between  the  hemi- 
spheres of  the  brain,  or  immediately  above  the  corpus  callosum.  Altho' 
there  seems  to  be  a  communication  between  the  two  anterior  ventricles; 
yet,  in  two  cases,  I  found  one  of  them  much  distended,  while  the  other 
contained  but  little  water. 

The  quantity  of  water  contained  in  the  ventricles  of  the  brain  was 
generally  from  two  ounces  to  five;  but  I  have  been  told  of  one  case  in 
which  it  amounted  to  near  eight  ounces.  This  fluid  does  not  coagulate 
with  heat,  like  the  scrum  of  the  blood,  or  the  lymph  that  is  found  in  the 
pericardium,  or  what  is  taken  from  the  abdomen  by  tapping  in  a  dropsy; 
and  this  difference  seems  to  be  owing  to  the  exhaling  arteries  of  the 
brain  being  much  smaller  than  those  of  the  other  parts. 

THE   DIAGNOSTIC   SIGNS   OF   A   DROPSY   WITHIN   THE   BRAIN 

Having  given  an  account  of  all  the  various  symptoms  commonly 
attending  a  collection  of  water  in  the  brain,  I  shall  now  recapitulate 
such  of  them  as  are  the  surest  signs  by  which  we  may  distinguish  this 
disorder  from  others,  which  so  much  resemble  it  as  sometimes  to  deceive 
an  experienced  physician:  And  this  will  be  the  more  necessary,  as  the 
ancients  were  altogether  ignorant  of  the  disease,  and  as  few  of  the 
moderns  who  treat  of  it  seem  to  have  described  it  more  from  theory  than 
observation. 

While  most  of  the  later  writers  have  confounded  the  signs  of  a  dropsy 
in  the  ventricles  of  the  brain  with  those  of  the  hydrocephalus  externus, 


ROBERT  WHYTT  417 

a  few  have  more  reasonably  assigned  to  this  species  of  dropsy  such  symp- 
toms as  commonly  attend  a  compression  of  the  brain,  but  without  giving 
such  a  distinct  account  of  the  first  appearance  and  progress  of  this 
disorder  as  could  enable  a  physician  to  distinguish  it  from  others  of  the 
head,  from  worms,  from  a  foulness  in  the  stomach  and  bowels,  or  from 
a  slow  fever  ending  in  a  coma. 

I  have  already  observed,  that  in  the  first  stage  it  is  hard  to  discover 
this  internal  hydrocephalus.  But  when  we  meet  with  a  patient  under 
fifteen  or  sixteen  years  of  age,  seized  with  a  slow  fever  of  no  certain  type, 
and  irregular  in  its  accesssions  and  remissions;  when  in  that  fever  the 
patients  vomit  once  a  day,  or  once  in  two  or  three  days;  when  they  shun 
the  light,  and  complain  of  a  pain  in  the  crown  of  their  head,  or  over  their 
eyes,  after  the  fever  has  continued  for  some  time,  or  of  a  achs,  (as  they 
are  commonly  called) ;  but  it  is  observable,  that  in  such  cases  this  kind 
of  pulse  is  always  attended  with  a  cool  skin. 

When  therefore,  with  a  slow  and  irregular  pulse  we  meet  with 
thirst  and  a  feverish  heat,  watching,  a  strabismus,  or  double  sight,  a 
delirium,  and  screaming,  succeeding  the  symptoms  mentioned  in  the 
first  stage,  we  may  strongly  suspect  water  in  the  ventricles  of  the  brain. 
But  this  is  still  more  evident,  when  soon  after  the  patient  grows  comatose, 
the  pupil  dilates  and  loses  its  motion,  the  pulse  becomes  quick,  the  cheeks 
are  flushed,  the  tendons  start,  and  convulsions  follow. 

It  is  true  indeed,  that  some  of  these  very  symptoms  are  observed 
towards  the  end  of  common  fevers,  in  which,  from  the  brain  being  much 
affected,  the  patient  falls  into  a  coma  before  his  death.  But  a  fever  from 
water  in  the  brain  is  easily  distinguished  from  others,  by  attending  to 
the  whole  course  of  the  disease,  and  particularly  to  the  pulse,  which, 
after  having  been  at  first  quick,  becomes  slow  and  irregular;  and  lastly 
acquires  a  greater  frequency  than  ever.  Besides,  the  screaming,  squinting, 
and  dilatation  of  the  pupil,  rarely  occur  in  other  fevers. 

The  symptoms  of  no  distemper  resemble  these  of  water  in  the  brain 
so  much  as  those  which  arise  from  worms  in  the  stomach;  for  with  a 
slow  fever  there  is  a  want  of  appetite,  vomiting,  pain  in  the  head,  raving, 
and  convulsions;  but  when  worms  in  the  stomach  or  intestines  occasion 
a  slow  and  irregular  pulse,  the  patients  have  not  that  feverish  heat  so 
observable  in  the  internal  hydrocephalus. 

OF  THE   CAUSES   OF   A   DROPSY   IN   THE  VENTRICLES   OF   THE 

BRAIN 

The  immediate  cause  of  this  disease,  and  indeed  of  every  kind  of 
dropsy,  is  always  the  same,  viz.  such  a  state  of  the  parts  as  makes  the 
exhalant  arteries  throw  out  a  greater  quantity  of  fluids  than  the  absor- 
bent veins  can  take  up. 


4i8  PEDIATRICS  OF  THE  PAST 

This  may  be  owing  to  several  causes: 

i.  There  may  be  an  original  laxity,  or  weakness  in  the  brain,  whereby 
the  small  exhalant  arteries  of  the  ventricles  will  throw  out  the  lymph 
faster  than  the  absorbent  veins  can  imbibe  it. 

In  children  under  a  year  old,  I  have  frequently  met  with  a  hydrocele, 
or  collection  of  water  between  the  tunica  vaginalis  and  the  testicle,  from 
such  a  cause:  And  this  disease  I  have  cured  by  small  doses  of  rhubarb, 
by  applying  linen  cloths  dipt  in  brandy,  or  impregnated  with  the  fumes 
of  myrrh,  olibanum,  and  succinum,  to  the  scrotum,  and  by  supporting 
the  testicles  with  a  bandage  or  truss.  If  in  young  children  we  could 
discover  the  dropsy  of  the  brain  as  early  as  we  do  that  of  the  testicles, 
and  could  apply  our  remedies  as  near  to  the  part,  we  should  probably 
often  succeed  in  the  cure:  Tho'  a  dropsy  in  the  brain  would  always  be 
more  unfavourable,  as  the  circulation  there  is  slower  and  more  languid 
than  in  any  other  part. 

2.  Altho*  there  has  been  no  original  weakness  in  the  brain,  yet  it 
may  have  suffered  so  much  in  the  time  of  birth,  by  the  compression  of 
the  skull,  as  afterwards  to  give  rise  to  a  collection  of  water  in  its  cavities. 

3.  A  scirrhous  tumour  of  the  glandula  pituitaria,  or  in  any  part 
contiguous  to  the  ventricles  of  the  brain,  by  compressing  the  neigh- 
bouring trunks  of  the  absorbent  veins,  will  prevent  the  due  absorption 
of  that  fluid  which  the  small  arteries  constantly  exhale,  and  occasion  a 
dropsy  in  the  brain;  in  like  manner  as  a  scirrhous  liver,  spleen,  or  pancreas, 
are  often  the  cause  of  an  ascites.  As  a  proof  of  this,  we  may  observe  that 
M.  Petit  often  found  the  glandula  pituitaria  scirrhous  in  those  who  died 
of  a  dropsy  of  the  ventricles  of  the  brain. 

In  one  case  I  met  with  a  hard  tumour  within  the  right  thalamus 
nervorum  opticorum:  It  was  almost  as  large  as  a  small  hen's  egg,  of  a 
yellowish  colour  within,  and  of  a  firm  consistence. 

4.  Altho'  there  may  be  no  obstruction  in  any  part  of  the  brain,  a 
dropsy  may  be  formed  in  it,  merely  from  a  too  thin  or  watery  state  of 
the  blood.  When  the  blood  is  too  thin,  the  exhalant  arteries  will  pour 
forth  their  fluids  in  greater  quantity  than  usual;  while  the  bibulous  veins 
will  absorb  them  more  sparingly;  and  from  this  cause  the  water  will  be 
apt  to  accumulate,  either  in  the  abdomen,  thorax,  or  brain,  according 
as  one  or  other  of  these  parts  is  the  weakest.  I  have  known  an  instance  of 
a  dropsy  in  the  cavity  of  the  abdomen,  where  there  were  no  obstructed 
viscera  to  be  seen  after  death,  and  where  the  cause  of  the  disease  seemed 
to  be  no  other  than  a  dissolved  state  of  the  blood  joined  to  an  uncommon 
relaxation  of  the  vessels. 

About  fifteen  years  ago,  I  had  a  patient  who  died  of  the  hydrocepha- 
lus, probably  owing  to  this  cause;  for  this  child,  about  a  year  before  his 
death,  and  after  the  measles,  falling  into  a  bad  state  of  health,  the  blood 


ROBERT  WHYTT  419 

taken  from  his  arm  was  observed  to  be  preternaturally  thin.  From  this 
time  he  never  recovered  his  looks  or  strength;  and,  about  ten  months 
after,  the  symptoms  of  the  hydrocephalus  appeared.  In  this  case  I  thought 
it  probable,  that  the  water  began  to  be  collected  in  the  brain  soon  after 
the  measles,  which  first  broke  the  health  of  the  child,  and  then  the  blood 
became  too  watery. 

5.  A  suppression,  or  a  diminished  secretion  of  urine,  may  also  give 
rise  to  this  disease.  Thus  grown  people,  who  die  of  an  ischuria,  have 
often  water  in  the  ventricles  of  the  brain,  and  become  comatose  before 
their  death;  but  such  patients  generally  die  before  any  considerable 
quantity  of  water  is  collected  in  these  cavities. 

6.  Lastly,  in  tedious  chronic  diseases,  water  is  often  collected  in  the 
ventricles  of  the  brain,  as  well  as  in  the  cavity  of  the  pericardium,  but 
not  in  such  quantity  as  to  occasion  the  symptoms  of  a  dropsy  within  the 
brain. 

AN  ATTEMPT  TO   ACCOUNT   FOR   SOME   OF  THE   MOST   REMARK- 
ABLE  SYMPTOMS   ATTENDING  A   DROPSY   IN  THE  BRAIN 

In  general,  the  whole  symptoms  of  this  disease  proceed  from  different 
degrees  of  the  same  cause,  viz.  the  pressure  or  distension  of  the  parts 
of  the  brain,  occasioned  by  the  water  contained  in  its  ventricles. 

1.  The  loss  of  appetite  and  inclination  to  vomit,  are  owing  to  the 
disordered  state  of  the  brain,  between  which  and  the  stomach  there  is 
so  great  a  sympathy,  that  in  wounds  of  the  head,  where  the  brain  is 
hurt,  a  vomiting  is  almost  a  constant  symptom. 

2.  The  aversion  to  light,  in  the  first  and  second  stage  of  the  disease, 
proceeds  from  an  increased  sensibility  of  the  retina;  and  this  is  probably 
owing  to  the  irritation  of  the  tbalami  nervorum  opticorum,  in  consequence 
of  the  water  accumulated  in  the  anterior  ventricles  of  the  brain. 

3.  The  slow  irregular  pulse  in  the  second  stage.  The  motion  of  the 
heart  is  owing  to  the  irritation  of  the  returning  venous  blood  poured 
into  its  ventricles.  This  irritation,  however,  could  have  no  effect  upon 
the  heart,  were  it  not  for  its  sensibility,  which  depends  entirely  on  its 
nerves.  Wherefore,  in  a  hydrocephalus,  when  the  water  is  collected 
within  the  brain  in  such  quantity  as  to  press,  with  a  considerable  force, 
on  the  medullary  substance,  the  nerves  proceeding  from  it  will  in  some 
degree  lose  their  powers,  and  consequently  the  heart  will  be  less  sensible. 
And  hence  the  pulse  becomes  often  as  slow,  and  sometimes  slower  than 
in  a  natural  state,  altho'  there  be  a  real  fever  in  the  body;  which  fever, 
were  it  not  for  this  pressure  on  the  origin  of  the  nerves,  would  occasion 
a  quick  pulse. 

When,  in  this  disease  the  pulse  is  slow,  it  is  always  more  or  less  irregu- 
lar; and  this  may  also  be  owing  to  the  nerves  of  the  heart  being,  in 


42o  PEDIATRICS  OF  THE  PAST 

some  measure,  deprived  of  their  usual  power,  by  which  means  that 
organ  cannot  move  with  its  wonted  steadiness  and  regularity. 

4.  The  quick  pulse  in  the  third  stage.  Of  all  the  symptoms  that  attend 
a  dropsy  in  the  brain,  there  is  none  so  hard  to  be  accounted  for  as  the 
quick  pulse  towards  the  end.  For  if  the  pressure  of  the  water  occasioned 
the  slow  pulse  in  the  second  stage,  one  would  imagine  that  in  the  third, 
when  this  pressure  is  increased,  the  sensibility  of  the  heart  should  be  still 
more  impaired;  and  that  therefore  its  motion  should  be  slower,  instead 
of  being  quicker.  However,  we  find  in  fact,  that  the  pulse  is  remarkably 
quicker  towards  the  end,  when  the  pressure  of  the  water  must  be  greatest; 
let  us  therefore  inquire  what  may  probably  be  the  reason  of  this  symptom. 

When,  in  the  second  stage,  the  pressure  on  the  sides  of  the  ventricles 
of  the  brain  occasions  the  slow  irregular  pulse,  it  seems  to  produce  this 
effect,  by  lessening  the  sensibility  and  other  powers  of  the  cardiac  nerves. 
When  in  the  third  stage  the  water  increases,  this  pressure  must  be  greater; 
and  therefore  it  might  be  natural  to  think,  that  these  nerves  should  be 
rendered  still  more  unfit  for  performing  their  function.  But  we  must 
consider,  that  when  the  sides  of  the  ventricles  are  stretched  by  the  water 
beyond  a  certain  pitch,  the  violence  done  to  the  medullary  fibre*  of  the 
brain  causes  such  an  uncommon  irritation  as  must  quicken  the  pulse: 
For  in  animals  newly  dead  (where  we  must  suppose  the  nerves  to  be  still 
more  insensible  and  unfit  for  action,  than  in  the  third  stage  of  the 
hydrocephalus)  an  irritation  of  the  medulla  oblongata  restores  the  motion 
of  the  heart;  and  if,  as  I  have  observed  above,  the  volatile  salts  held 
to  the  nose,  or  cinnamon-water  taken  into  the  mouth,  by  their  stimulus, 
though  for  a  short  time,  give  new  vigour  to  the  nerves  of  the  uvea, 
(which  towards  the  end  of  this  disease  begin  to  lose  their  powers),  why 
may  not  the  irritation  of  the  medullary  part  of  the  brain,  occasioned 
by  the  immoderate  distension  of  its  ventricles,  so  affect  the  nerves  of 
the  heart  as  to  accelerate  its  motion? 

In  an  apoplexy,  the  pulse,  tho*  at  first  slow,  becomes  very  quick 
towards  the  end ;  and  indeed,  in  almost  every  disease,  the  pulse  is  uncom- 
monly quick  before  death,  not  because  the  nerves  of  the  heart  are  then 
more  sensible,  or  fitter  for  performing  their  office,  than  they  were  before, 
but  because  at  that  time  there  is  an  uncommon  struggle  in  the  body,  and 
all  its  powers  are  excited  into  action  by  the  great  irritation  of  the  brain 
and  nervous  system.  The  same  seems  to  be  the  case  in  those  who  are 
dying  of  a  dropsy  in  the  brain;  for  howsoever  much  the  medullary  part 
of  the  brain  may  be  compressed,  yet  the  convulsions  which  happen  in 
the  last  stage  show  that  the  brain  and  nerves  are  sensible  of  irritation, 
and  still  retain  their  power  of  putting  the  muscles  in  motion. 

5.  The  dilataiion  of  the  pupil.  The  contraction  of  the  pupil  is  owing 
to  the  uneasy  sensation  excited  in  the  retina  by  too  much  light;  and 


ROBERT  WHYTT  421 

hence  it  is,  that  in  a  dark  place,  or  when  the  retina  becomes  insensible 
of  the  stimulus  of  light,  the  pupil  is  always  observed  to  be  wide.  In 
the  hydrocephalus,  when  the  water  in  the  ventricles  presses  so  much  on 
the  thalami  nervorum  opticorum  as  to  render  the  optic  nerves  in  a  great 
measure  insensible,  the  retina  will  no  longer  feel  the  impression  of  light; 
and  therefore  the  pupil  will  remain  dilated. 

In  the  account  of  the  symptoms  of  the  third  stage,  I  mentioned  an 
instance  of  a  boy  five  years  of  age,  whose  pupils  were  much  dilated  on 
the  fifth  day  before  he  died;  but  we  observed  them  next  day  to  be  as 
much  contracted  as  is  usual  in  a  person  in  health  placed  in  a  moderate 
light.  At  this  time,  having  endeavoured  to  rouse  the  patient,  by  holding 
a  volatile  spirit  to  his  nose,  and  making  him  swallow  some  cinnamon- 
water,  the  pupil  instantly  became  as  wide  as  it  had  been  the  night  before. 
In  about  half  an  hour  after,  I  found  the  pupils  again  contracted; 
but  they  were  presently  enlarged  as  before,  upon  holding  the  spirit  of 
sal.  ammoniacus  to  his  nose.  This  experiment  I  repeated  four  times 
in  two  days,  and  always  with  the  same  success. 

In  this  case  the  dilatation  of  the  pupil  was  at  first  owing  to  the  com- 
pression of  the  thalami  nervorum  opticorum  by  the  water  contained  in 
the  anterior  ventricles  of  the  brain.  But  soon  after,  the  origin  of  those 
nerves  which  serve  the  uvea  being  also  considerably  compressed  by  the 
increased  quantity  of  water,  the  longitudinal  fibres  of  this  membrane 
(which  by  their  natural  contractility  dilate  the  pupil)  became  paralytic 
and  flaccid,  as  happens  in  the  bodies  some  time  after  death;  wherefore 
the  edges  of  the  pupil  being  less  drawn  outward,  of  course  it  would  become 
smaller. 

The  volatile  spirits  applied  to  the  nose,  by  irritating  its  nerves,  so 
affected  the  brain  as  to  give  some  vigour  for  a  short  time  to  the  nerves  of 
the  uvea,  by  which  means  its  longitudinal  fibres,  regaining  their  power 
of  contraction,  immediately  dilated  the  pupil;  but  as  soon  as  the  effect 
of  this  stimulus  ceased,  the  fibres  of  the  uvea  being  again  deprived  of 
their  contractility,  the  pupil  returned  to  its  former  dimensions. 

6.  The  slow  respiration  towards  the  end  of  the  disease.  In  this  kind 
of  breathing  (which  I  have  also  observed  in  patients  who  died  of  an 
apoplexy  and  in  ischuria)  there  is  a  considerable  pause  after  every 
expiration  before  a  new  inspiration  succeeds.  This  pause  is  ordinarily 
for  a  few  seconds;  but  I  have  sometimes  observed  it  longer;  and  in  one 
apoplectic  case  it  continued  above  half  a  minute.  Now  the  brain  being 
greatly  compressed,  the  uneasy  sensation  arising  from  the  difficulty 
the  blood  finds  in  passing  through  the  lungs  will  be  much  less  felt  than 
usual:  Hence,  after  expiration  (which  is  performed  by  the  power  the 
cartilages  of  the  ribs  have  to  restore  themselves)  a  long  pause  intervenes 
before  a  new  inspiration  takes  place;  because  the  mind  is  not  excited 


422  PEDIATRICS  OF  THE  PAST 

to  put  in  motion  the  muscles  concerned  in  inspiration  till  the  sense  of 
suffocation  in  the  breast  becomes  so  great  as  to  rouse,  as  it  were,  the 
sentient  principle  from  its  lethargic  state. 

OF  THE  CURE  OF  A  DROPSY  IN  THE  BRAIN 

If  this  disease  could  be  known  early,  and  before  an  considerable 
quantity  of  water  has  been  collected,  it  might  probably  be  sometimes 
cured  by  purgatives,  diuretics,  blisters,  frictions,  exercise,  and  diet. 
But  as  it  never  discovers  itself  till  so  much  water  is  accumulated  as,  by 
its  pressure  on  the  sides  of  the  ventricles,  to  disturb  the  action  of  the 
brain,  we  have  little  to  hope  from  any  medicine.  An  ascites  indeed  has 
been  often  cured  by  diuretics,  or  purgatives.  But  if  we  consider  the 
distance  between  the  brain  and  the  abdomen,  (where  these  medicines 
by  stimulus  increase,  in  a  particular  manner,  the  action  of  the  absorbents, 
at  the  same  time  they  evacuate  the  watery  part  of  the  blood),  the 
extremely  slow  motion  of  the  fluids  in  the  small  vessels  of  the  brain,  and 
the  pressure  of  the  water  on  the  sides  of  its  ventricles,  which  must 
render  the  absorption  of  that  fluid  still  more  difficult,  we  shall  see  the 
reason  why  diuretics  and  cathartics  should  be  so  inefficacious  here. 

In  an  ascites  the  patient  is  generally  relieved,  and  sometimes  cured  by 
tapping;  but  in  a  dropsy  of  the  ventricles  of  the  brain,  any  such  attempt 
to  draw  off  the  water,  could  have  no  other  effect  than  to  hasten  death. 

I  freely  own  that  I  have  never  been  so  lucky  as  to  cure  one  patient 
who  had  those  symptoms  which  with  certainty  denote  this  disease  (The 
medicines  I  chiefly  used  were  repeated  purges  of  rhubarb  or  jalap,  with 
calomel  and  blisters;  by  which  last  I  have  seen  the  patients  somewhat 
relieved  for  a  short  time  in  the  second  stage.  I  have  also  ordered  the 
powder  of  asarum  to  be  drawn  up  into  the  nostrils,  with  a  view  to  make  a 
discharge  of  a  water  humour  from  the  vessels  of  the  head.) ;  and  I  suspect 
that  those  who  imagine  they  have  been  more  successful,  have  mistaken 
another  distemper  for  this.  I  remember  several  years  ago,  that  an  able 
and  experienced  physician  being  called  to  a  child  of  a  year  old,  in  a  fever 
attended  with  convulsions  and  a  comay  was  of  opinion,  that  the  disorder 
proceeded  from  water  in  the  head;  on  which  account,  besides  blisters 
which  had  been  applied  before,  he  ordered  a  purge  of  jalap  and  calomel, 
which  had  a  very  good  effect;  for  in  two  or  three  days  the  convulsions 
ceased,  and  the  patient  soon  recovered ;  which,  I  am  persuaded,  could  not 
have  been  the  case,  had  he  laboured  under  a  dropsy  of  the  brain.  Farther, 
this  child  was  not  only  suddenly  seized  with  the  fever,  (as  commonly 
happens  when  it  takes  to  the  head),  but  at  no  time  of  his  illness  had  he 
either  an  irregular  or  slow  pulse,  or  indeed  any  number  of  the  other 
symptoms  which  I  consider  as  essential  for  distinguishing  the  hydro- 
cephalus internus  from  another  disease. 


BENJAMIN  RUSH 

[1745-1813] 

IT  is  curious  that  no  adequate  life  of  Benjamin  Rush  has 
ever  been  written.  It  is  true  that  he  has  been  the  subject  of 
numerous  essays  and  Harry  G.  Good  has  written  his  life  with 
reference  to  his  services  to  education,  but  there  still  remains  the 
great  opportunity  for  some  medical  man  to  study  and  write  the 
story  of  his  eventful  and  useful  life. 

Rush  was  a  many-sided  man,  full  of  energy  and  enthusiasm, 
a  hard  worker,  a  reformer,  an  educator,  a  politician,  a  writer, 
an  editor  and  above  all,  a  physician.  He  was  born  in  Philadelphia 
County,  Pennsylvania,  on  Christmas  eve,  1745  (°-  s-)  and  died  on 
April  19,  18 13.  He  came  of  English  dissenting  stock  on  both  sides, 
which  may  have  accounted  for  his  religious  views,  his  piety,  his 
desire  to  reform  mankind.  As  a  young  boy  of  eight  or  more  he 
was  sent  to  an  academy  in  Nottingham,  Maryland,  run  by  the 
Reverend  Samuel  Finley,  afterwards  president  of  the  College  of 
New  Jersey,  now  Princeton  University.  After  five  years  he  was 
sent  to  the  College  of  New  Jersey  and  he  received  his  a.  b.  degree 
in  1760,  before  he  was  fifteen  years  of  age.  From  school  he  went 
to  Dr.  John  Redman  in  Philadelphia  with  whom  he  remained 
until  July,  1766.  His  biographer  Good  says  that  during  this 
period  he  was  away  from  work  only  eleven  days  and  spent  only 
three  evenings  outside  Dr.  Redman's  house,  a  contrast  to  the 
young  men  of  these  days.  He  attended  two  courses  of  lectures  by 
Dr.  Shippen  and  Dr.  Morgan.  About  this  time  George  White- 
field  preached  in  Philadelphia  and  Rush,  concerned  about  "his 
religious  condition  and  situation"  as  he  puts  it,  joined  the  Pres- 
byterian church.  About  this  time  he  started  to  write,  his  maiden 
effort  was  a  Eulogium  on  the  Rev.  Gilbert  Tennent.  Rush  was  a 
patriot,  a  troublesome  one  no  doubt,  and  his  political  activities 
began  in  1765  with  his  denouncing  the  Stamp  Act.  Incidentally 
he  vented  considerable  spleen  on  Franklin.  The  next  year  he  went 

423 


424  PEDIATRICS  OF  THE  PAST 

to  Edinburgh  and  received  his  degree  in  June,  1768.  His  thesis 
was  on  the  digestion  of  food  in  the  stomach.  While  in  Edinburgh 
Rush  studied  languages  and  eventually  gained  a  reading  knowl- 
edge of  French,  Italian  and  Spanish.  Leaving  Edinburgh  he  went 
to  London  for  further  clinical  study  and  while  there  lived  in  the 
house  of  Franklin,  his  ideas  concerning  that  worthy  evidently 
having  undergone  a  marked  change.  He  was  enabled  through 
Franklin  to  meet  a  great  many  of  the  famous  men  of  the  day, 
and  through  the  same  man's  generosity  was  enabled  to  visit 
Paris  where  he  met  Diderot,  Mirabeau  and  others.  Soon  after  he 
returned  to  London  and  sailed  for  home.  In  June,  1769,  he  was 
made  professor  of  chemistry  in  the  College  of  Philadelphia  and 
he  set  up  a  shop  of  his  own  and  soon  had  a  large  practice  among 
the  poor  of  the  city. 

Rush  had  studied  under  CuIIen  and  while  he  opposed  some 
of  that  teacher's  theories,  and  himself  formulated  what  Garrison 
calls  "a  modified  Brunonianism,"  he  had  little  tolerance  for 
the  opinions  of  others.  In  Philadelphia  many  of  the  practitioners 
followed  the  system  of  Boerhaave  (it  was  the  age  of  systems) 
so  Rush  was  not  popular  with  his  fellow  medical  men  when  he 
drank  a  toast  to  the  "Speedy  interment  to  the  system  of  Dr. 
Boerhaave,  and  may  it  never  rise  again." 

Rush  married  on  January  1 1 ,  1 776.  Before  this  time  he  began 
to  mingle  in  politics  and  met  many  of  the  leaders,  among  them 
John  Adams,  with  whom  he  became  most  friendly.  Adams  wrote 
of  him  about  this  time,  "Dr.  Rush  came  in.  He  is  an  elegant, 
ingenious  body,  a  sprightly  pretty  fellow.  He  is  a  republican.  .  .  . 
But  Rush  I  think  is  too  much  of  a  talker  to  be  a  deep  thinker; 
elegant,  not  great." 

In  1775  Rush  was  made  a  surgeon  of  a  fleet  of  gunboats  on 
the  Delaware  but  resigned  to  become  one  of  a  committee  to  con- 
duct a  saltpeter  factory.  In  June,  1776,  he  was  a  member  of  the 
Provincial  Congress  and  moved  the  appointment  of  a  com- 
mittee to  draw  a  declaration  on  the  question  of  independence. 
He  previously  had  induced  Paine  to  write  "Common  Sense" 
which  was  put  out  anonymously  in  January,  1776.  Rush  was  a 
signer  of  the  Declaration.  He  served  with  the  army,  in  1777  was 
made  surgeon-general  of  the  armies  of  the  Middle  Department 
and  later  his  title  was  changed  to  physician-general  to  the  military 
hospitals  in  the  same  district.  In  January,  1778,  he  resigned  after 


BENJAMIN  RUSH  425 

having  accused  Shippen  of  malpractices  in  the  matter  of  hospital 
supplies.  Shippen  was  acquitted.  An  unsigned  letter  to  Patrick 
Henry,  about  the  conditions  of  the  troops  and  criticizing  affairs 
freely,  was  forwarded  to  Washington  who  recognized  the  hand- 
writing. Rush  fell  into  great  disfavor  and  there  has  been  great 
discussion  concerning  his  attitude  at  this  time.  One  gets  the 
impression  that  he  was  doing  what  he  thought  right. 

Rush  went  back  to  his  practice  and  his  teaching,  but  was  a 
delegate  to  the  Pennsylvania  General  Assembly  when  the  Federal 
Constitution  was  submitted  for  ratification. 

It  would  take  us  too  far  afield  to  go  into  detail  concerning 
Rush  and  medical  education.  When  the  Assembly  dissolved 
the  Board  of  Trustees  and  the  Faculty  in  1 779  he  was  out  of  a 
teaching  position.  The  University  of  Pennsylvania  was  formed 
and  Rush  was  not  given  a  position  on  account  of  the  offense 
he  had  given  in  his  letter  when  he  first  declined  to  serve  in  the 
new  institution.  In  1789  the  College  of  Philadelphia  was  given 
back  its  charter,  building  and  funds,  and  Rush  resumed  his  old 
position,  subsequently  was  made  professor  of  the  theory  and 
practice  of  medicine  and  when  in  1791  the  College  and  the  Uni- 
versity were  united,  the  title  of  his  chair  was  changed  to  pro- 
fessor of  the  institutes  of  medicine  and  clinical  practice ;  later  he 
was  made  professor  of  physic  to  fill  the  place  left  vacant  by  the 
death  of  Adam  Kuhn.  Rush  remained  in  these  positions  until 
he  died.  Rush  was  physician  to  the  Pennsylvania  Hospital  and 
was  largely  instrumental  in  founding  the  first  dispensary  in  this 
country,  the  Philadelphia  dispensary.  His  political  activities  led 
to  his  appointment  as  treasurer  of  the  United  States  mint,  a 
position  held  by  him  for  about  fourteen  years. 

The  account  of  Rush's  practice  and  of  his  service  during  the 
yellow  fever  epidemic  would  make  good  reading.  He  himself 
wrote  a  wonderfully  vivid  description  of  the  epidemic  and  its 
effects  upon  the  inhabitants  as  well  as  of  his  own  strenuous  efforts 
to  give  the  sufferers  relief.  He  was  great  on  therapeutics  and 
purged  and  sweat  and  bled  at  a  great  rate,  in  fact  he  rivalled 
Sangrado  in  this  regard.  As  a  physician  Rush  has  been  likened 
to  Sydenham,  whose  habits  of  observations  he  followed.  What- 
ever the  merits  of  his  therapeutics,  there  is  no  doubt  that  he  was 
a  keen  observer  and  his  description  of  cholera  infantum  places 
him  among  those  who  contributed  to  pediatrics  in  the  early  days. 


426  PEDIATRICS  OF  THE  PAST 

He  noted  the  cure  of  joint  disease  by  removing  diseased  teeth, 
wrote  on  dengue,  on  the  effect  of  alcohol  on  the  mind  and  on 
various  diseases.  His  book  on  insanity  was  popular  for  a  long 
while;  he  wrote  a  most  readable  treatise  on  the  diseases  of  the 
American  Indians  and  also  gave  later  an  account  of  their  vices. 
He  contributed  valuable  papers  on  anthropology  and  on  the 
hygiene  of  troops.  He  wrote  as  a  reformer  on  the  subjects  of 
alcohol,  slavery,  war  and  the  death  penalty.  He  helped  largely 
in  the  founding  of  Dickinson  College  and  wrote  extensively  on 
educational  topics.  He  had  a  pleasant,  fluent  style,  easy  to  read, 
and  understood  how  to  keep  the  reader's  interest  from  flagging. 
He  received  recognition  both  at  home  and  abroad.  His  work, 
"An  Account  of  the  Bilious  Remitting  Yellow  Fever  As  It 
Appeared  in  the  City  of  Philadelphia  in  the  Year  1793,"  brought 
him  a  diamond  from  the  Czar  of  Russia,  medals  from  Prussia 
and  Etruria,  and  later  two  medals  were  struck  in  his  honor  at 
the  mint.  He  left  an  indelible  impression  on  early  American  life 
and  particularly  on  medicine.  Of  his  contribution  to  pediatrics 
his  paper  on  "Cholera  Infantum"  is  the  most  important,  as  he 
was  the  first  writer  to  give  anything  like  a  systematic  account. 
It  is  indeed  curious  that  the  diarrheal  diseases  of  children  received 
so  little  attention.  Practically  all  writers  on  pediatrics  mention 
diarrhea,  "watery  gripes/'  and  the  cause  of  the  disease  was 
ascribed  to  various  things,  an  acid  condition  was  one  of  the 
favorites.  Many  suggestions  were  made  for  the  treatment,  but 
Rush  was  the  first  to  connect  the  disease  with  the  hot  weather. 


AN  INQUIRY 

Into  The 

Cause  and  Cure 

of  the 

CHOLERA  INFANTUM 

By  this  name  I  mean  to  designate  a  disease,  called  in  Philadelphia, 
the  "vomiting  and  purging  of  children."  From  the  regularity  of  its 
appearance  in  the  summer  months,  it  is  likewise  known  by  the  name  of 
"the  disease  of  the  season."  It  prevails  in  most  of  the  large  towns  of 
the  United  States.  It  is  distinguished  in  Charleston,  in  South  Carolina, 
by  the  name  of  "the  April  and  May  disease,"  from  making  its  first 
appearance  in  those  two  months.  It  seldom  appears  in  Philadelphia 


BENJAMIN  RUSH  427 

till  the  middle  of  June,  or  the  beginning  of  July,  and  generally  continues 
till  near  the  middle  of  September.  Its  frequency  and  danger  are  always 
in  proportion  to  the  heat  of  the  weather.  It  affects  children  from  the  first 
or  second  week  after  their  birth,  till  they  are  two  years  old.  It  sometimes 
begins  with  a  diarrhea,  which  continues  for  several  days  without  any 
other  symptom  of  indisposition;  but  it  more  frequently  comes  on  with  a 
violent  vomiting  and  purging,  and  a  high  fever.  The  matter  discharged 
from  the  stomach  and  bowels  is  generally  yellow  or  green,  but  the  stools 
are  sometimes  slimy  and  bloody,  without  any  tincture  of  bile.  In  some 
instances  they  are  nearly  as  limpid  as  water.  Worms  are  frequently 
discharged  in  each  kind  of  the  stools  that  has  been  described.  The 
children,  in  this  stage  of  the  disease,  appear  to  suffer  a  good  deal  of  pain. 
They  draw  up  their  feet,  and  are  never  easy  in  one  posture.  The  pulse 
is  quick  and  weak.  The  head  is  unusually  warm,  while  the  extremities 
retain  their  natural  heat,  or  incline  to  be  cold.  The  fever  is  of  the  remit- 
ting kind,  and  discovers  evident  exacerbations,  especially  in  the  evenings. 
The  disease  affects  the  head  so  much,  as  in  some  instances  to  produce 
symptoms  not  only  of  delirium,  but  of  mania,  insomuch  that  the  children 
throw  their  heads  backwards  and  forwards,  and  sometimes  make 
attempts  to  scratch,  and  to  bite  their  parents,  nurses,  and  even  them- 
selves. A  swelling  frequently  occurs  in  the  abdomen,  and  in  the  face  and 
limbs.  An  intense  thirst  attends  every  stage  of  the  disease.  The  eyes 
appear  languid  and  hollow,  and  the  children  generally  sleep  with  them 
half  closed.  Such  is  the  insensibility  of  the  system  in  some  instances  in 
this  disease,  that  flies  have  been  seen  to  alight  upon  the  eyes  when  open, 
without  exciting  a  motion  in  the  eyelids  to  remove  them.  Sometimes 
the  vomiting  continues  without  the  purging,  but  more  generally  the 
purging  continues  without  the  vomiting,  through  the  whole  course  of 
the  disease.  The  stools  are  frequently  large,  and  extremely  fetid,  but  in 
some  instances  they  are  without  smell,  and  resemble  drinks  and  aliments 
which  have  been  taken  into  the  body.  The  disease  is  sometimes  fatal  in  a 
few  days.  I  once  saw  it  carry  off  a  child  in  four  and  twenty  hours. 
Its  duration  is  varied  by  the  season  of  the  year,  and  by  the  changes  in 
the  temperature  of  the  weather.  A  cool  day  frequently  abates  its 
violence,  and  disposes  it  to  a  favourable  termination.  It  often  continues, 
with  occasional  variations  in  its  appearance,  for  six  weeks  or  two  months. 
Where  the  disease  has  been  of  long  continuance,  the  approach  of  death 
is  gradual,  and  attended  by  a  number  of  distressing  symptoms.  An 
emaciation  of  the  body  to  such  a  degree,  that  the  bones  come  through 
the  skin,  livid  spots,  a  singultus,  convulsions,  a  strongly  marked  hippo- 
cratic  countenance,  and  a  sore  mouth,  generally  precede  the  fatal 
termination  of  this  disease.  Few  children  ever  recover,  after  the  last 
symptoms  which  have  been  mentioned  make  their  appearance. 


428  PEDIATRICS  OF  THE  PAST 

This  disease  has  been  ascribed  to  several  causes;  of  each  of  which 
I  shall  take  notice  in  order. 

i.  It  has  been  attributed  to  dentition.  To  refute  this  opinion,  it 
will  be  necessary  to  observe,  that  it  appears  only  in  one  season  of  the  year. 
Dentition,  I  acknowledge,  sometimes  aggravates  it;  hence  we  find  it  is 
most  severe  in  that  period  of  life,  when  the  greatest  number  of  teeth 
make  their  appearance,  which  is  generally  about  the  ioth  month.  I 
think  I  observed  more  children  to  die  of  this  disease  at  that  age,  than  at 
any  other. 

ii.  Worms  have  likewise  been  suspected  of  being  the  cause  of  this 
disease.  To  this  opinion,  I  object  the  uncertainty  of  worms  ever  produc- 
ing an  idiopathic  fever,  and  the  improbability  of  their  combining  in  such 
a  manner  as  to  produce  an  annual  epidemic  disease  of  any  kind.  But 
further,  we  often  see  the  disease  in  all  its  force,  before  that  age,  in  which 
worms  usually  produce  diseases;  we  likewise  often  see  it  resist  the  most 
powerful  anthelmintic  medicines;  and,  lastly,  it  appears  from  dissection, 
where  the  disease  has  proved  fatal,  that  not  a  single  worm  has  been 
discovered  in  the  bowels.  It  is  true,  worms,  are  in  some  instances  dis- 
charged in  this  disease,  but  they  are  frequently  discharged  in  greater 
numbers  in  the  hydrocephalus  internus,  and  in  the  small  pox,  and  yet 
who  will  assert  either  of  those  diseases  to  be  produced  by  worms. 

in.  The  summer  fruits  have  been  accused  of  producing  this  disease. 
To  this  opinion  I  object,  that  the  disease  is  but  little  known  in  country 
places,  where  children  eat  much  more  fruit  than  in  cities.  As  far  as  I  have 
observed,  I  am  disposed  to  believe,  that  the  moderate  use  of  ripe  fruits, 
rather  tends  to  prevent,  than  to  induce  the  disease. 

From  the  discharge  of  bile  which  generally  introduces  the  disease, 
from  the  remissions  and  exacerbations  of  the  fever  which  accompanies 
it,  and  from  its  occurring  nearly  in  the  same  season  with  the  cholera  and 
remitting  fever  in  adults,  I  am  disposed  to  consider  it  as  a  modification 
of  the  same  diseases.  Its  appearance  earlier  in  the  season  than  the  cholera 
and  remitting  fever  in  adults,  must  be  ascribed  to  the  constitutions  of 
children  being  more  predisposed  from  weakness  to  be  acted  upon,  by  the 
remote  causes  which  produce  those  diseases. 

I  shall  now  mention  the  remedies  which  are  proper  and  useful  in 
this  disease. 

i.  The  first  indication  of  cure  is  to  evacuate  the  bile  from  the  stomach 
and  bowels.  This  should  be  done  by  gentle  doses  of  ipecacuanha,  or 
tartar  emetic.  The  vomits  should  be  repeated  occasionally,  if  indicated,  in 
every  stage  of  the  disease.  The  bowels  should  be  opened  by  means  of 
calomel,  manna,  castor  oil,  or  magnesia.  I  have  generally  found  rhubarb 
improper  for  this  purpose,  while  the  stomach  was  in  a  very  irritable  state. 
In  those  cases,  where  there  is  reason  to  believe  that  the  offending  con- 


BENJAMIN  RUSH  429 

tents  of  the  primae  viae  have  been  discharged  by  nature  (which  is  often 
the  case),  the  emetics  and  purges  should  by  no  means  be  given;  but, 
instead  of  them,  recourse  must  be  had  to 

11.  Opiates.  A  few  drops  of  liquid  laudanum,  combined  in  a  testace- 
ous julep,  with  peppermint  or  cinnamon-water,  seldom  fail  of  composing 
the  stomach  and  bowels.  In  some  instances,  this  medicine  alone  subdues 
the  disease  in  two  or  three  days ;  but  where  it  does  not  prove  so  successful, 
it  produces  a  remission  of  pain,  and  of  other  distressing  symptoms,  in 
every  stage  of  the  disease. 

in.  Demulcent  and  diluting  drinks  have  an  agreeable  effect  in  this 
disease.  Mint  and  mallow  teas,  or  a  tea  made  of  blackberry  roots  infused 
in  cold  water,  together  with  a  decoction  of  the  shavings  of  hartshorn 
and  gum  arabic  with  cinnamon,  should  all  be  given  in  their  turns  for 
this  purpose. 

iv.  Clysters  made  of  flaxseed  tea,  or  of  mutton  broth,  or  of  starch 
dissolved  in  water,  with  a  few  drops  of  liquid  laudanum  in  them,  give 
ease,  and  produce  other  useful  effects. 

v.  Plasters  of  Venice  treacle  applied  to  the  region  of  the  stomach, 
and  flannels  dipped  in  infusions  of  bitter  and  aromatic  herbs  in  warm 
spirits,  or  Madeira  wine,  and  applied  to  the  region  of  the  abdomen,  often 
afford  considerable  relief. 

vi.  As  soon  as  the  more  violent  symptoms  of  the  disease  are  composed, 
tonic  and  cordial  medicines  should  be  given.  The  bark  in  decoction,  or  in 
substance  (where  it  can  be  retained  in  that  form),  mixed  with  a  little 
nutmeg,  often  produces  the  most  salutary  effects.  Port  wine  or  claret 
mixed  with  water  are  likewise  proper  in  this  stage  of  the  disease.  After 
the  disease  has  continued  for  some  time,  we  often  see  an  appetite 
suddenly  awakened  for  articles  of  diet  of  a  stimulating  nature.  I  have 
seen  many  children  recover  from  being  gratified  in  an  inclination  to  eat 
salted  fish,  and  the  different  kinds  of  salted  meat.  In  some  instances  they 
discover  an  appetite  for  butter,  and  the  richest  gravies  of  roasted  meats, 
and  eat  them  with  obvious  relief  to  all  their  symptoms.  I  once  saw  a 
child  of  sixteen  months  old  perfectly  restored,  from  the  lowest  stage  of 
this  disease,  by  eating  large  quantities  of  rancid  English  cheese,  and 
drinking  two  or  three  glasses  of  port  wine  every  day.  She  would  in  no 
instance  eat  bread  with  the  cheese,  nor  taste  the  wine,  if  it  was  mixed 
with  water. 

We  sometimes  see  relief  given  by  the  use  of  the  warm  bath,  in  cases 
of  obstinate  pain.  The  bath  is  more  effectual,  if  warm  wine  is  used, 
instead  of  water. 

I  have  had  but  few  opportunities  of  trying  the  effects  of  cold  water 
applied  to  the  body  in  this  disease;  but  from  the  benefit  which  attended 
its  use  in  the  cases  in  which  it  was  prescribed,  I  am  disposed  to  believe 


430  PEDIATRICS  OF  THE  PAST 

that  it  would  do  great  service,  could  we  overcome  the  prejudices  which 
subsist  in  the  minds  of  parents  against  it. 

After  all  that  has  been  said  in  favour  of  the  remedies  that  have  been 
mentioned,  I  am  sorry  to  add,  that  I  have  very  often  seen  them  all 
administered  without  effect.  My  principal  dependence,  therefore,  for 
many  years,  has  been  placed  upon 

vn.  Country  air.  Out  of  many  hundred  children  whom  I  have  sent 
into  the  country,  in  every  stage  of  this  disease,  I  have  lost  but  three; 
two  of  whom  were  sent,  contrary  to  my  advice,  into  that  unhealthy  part 
of  the  neighborhood  of  Philadelphia  called  the  Neck,  which  lies  between 
the  city  and  the  conflux  of  the  rivers  Delaware  and  Schuylkill.  I  have 
seen  one  cure  performed  by  this  remedy,  after  convulsions  had  taken 
place.  To  derive  the  utmost  benefit  from  the  country  air,  children  should 
be  carried  out  on  horseback,  or  in  a  carriage,  every  day;  and  they 
should  be  exposed  to  the  open  air  as  much  as  possible  in  fair  weather, 
in  the  day  time.  Where  the  convenience  of  the  constant  benefit  of  coun- 
try air  cannot  be  obtained,  I  have  seen  evident  advantages  from  taking 
children  out  of  the  city  once  or  twice  a  day.  It  is  extremely  agreeable 
to  see  the  little  sufferers  revive  as  soon  as  they  escape  from  the  city  air, 
and  inspire  the  pure  air  of  the  country. 

I  shall  conclude  this  inquiry,  by  recommending  the  following  methods 
of  preventing  this  disease,  all  of  which  have  been  found,  by  experience  to 
be  useful. 

i.  The  daily  use  of  the  cold  bath. 

2.  A  faithful  and  attentive  accommodation  of  the  dresses  of  children 
to  the  state  and  changes  of  the  air. 

3.  A  moderate  quantity  of  salted  meat  taken  occasionally  in  those 
months  in  which  the  disease  usually  prevails.  It  is  perhaps  in  part  from 
the  daily  use  of  salted  meat  in  diet,  that  the  children  of  country  people 
escape  this  disease. 

4.  The  use  of  sound  old  wine  in  the  summer  months.  From  a  tea 
spoon  full,  to  half  a  wine  glass  full,  according  to  the  age  of  the  child, 
may  be  given  every  day.  It  is  remarkable,  that  the  children  of  persons  in 
easy  circumstances,  who  sip  occasionally  with  their  parents  the  remains 
of  a  glass  of  wine  after  dinner,  are  much  less  subject  to  this  disease,  than 
the  children  of  poor  people,  who  are  without  the  benefit  of  that  article  of 
diet. 

5.  Cleanliness,  both  with  respect  to  the  skin  and  clothing  of  children. 
Perhaps  the  neglect  of  this  direction  may  be  another  reason  why  the 
children  of  the  poor  are  most  subject  to  this  disease. 

6.  The  removal  of  children  into  the  country  before  the  approach  of 
warm  weather.  This  advice  is  peculiarly  necessary  during  the  whole 
period  of  dentition.  I  have  never  known  but  one  instance  of  a  child  being 


BENJAMIN  RUSH  431 

affected  by  this  disease,  who  had  been  carried  into  the  country  in  order 
to  avoid  it. 

I  have  only  to  add  to  the  above  observations,  that  since  the  preva- 
lence of  the  yellow  fever  in  Philadelphia  after  the  year  1793,  the  cholera 
infantum  has  assumed  symptoms  of  such  malignity,  as  to  require 
bleeding  to  cure  it.  In  some  cases,  two  and  three  bleedings  were  necessary 
for  that  purpose. 


HEZEKIAH  BEARDSLEY 

[  1 748-1 790] 

THIS  old  worthy,  one  of  the  bright  lights  of  early  American 
pediatrics,  has  strangely  enough  eluded  the  medical  historian. 
His  fame  rests  on  his  remarkable  description  of  congenital 
pyloric  stenosis.  Dr.  Walter  Steiner,  of  Hartford,  gave  an  account 
of  him  before  the  Connecticut  State  Medical  Society  in  1908  and 
most  of  the  following  facts  have  been  furnished  by  Dr.  Steiner. 

Beardsley  is  mentioned  by  Bronson,  in  his  "Medical  History 
and  Biography,"  and  he  is  referred  to  by  Russell  in  the  Con- 
necticut State  Medical  Society  Transactions  for  1892.  He,  or  a 
relative  who  practiced  in  Hartford,  must  have  been  a  corre- 
spondent of  Benjamin  Rush,  for  the  latter  mentions  a  Beardsley 
in  his  "Medical  Inquiries  and  Observations"1  in  an  article  on 
the  "Diseases  of  Military  Hospitals." 

In  fevers  and  dysenteries,  those  soldiers  recovered  most  certainly, 
and  most  speedily,  who  lay  at  the  greatest  distance  from  the  walls  of  the 
hospitals.  This  important  fact  was  communicated  to  me  by  the  late 
Dr.  Beardsley,  of  Connecticut. 

Although  a  member  of  the  New  Haven  County  Medical 
Society,  Beardsley  was  a  resident  of  Hartford  County,  Con- 
necticut, "living  first  at  Southington,  where  he  appears  to  have 
practised  medicine  as  far  as  his  health  would  permit.  He  also 
kept  a  drug  store  in  a  location,  at  one  time,  'a  few  rods  east  of 
the  Court  House/  but  we  have  no  information  as  to  whether  he 
acted  here  as  a  practising  physician.  His  poor  health  gravely 
interfered  with  his  business  and  caused  him  to  go  to  Savannah 
in  1789.  He  died  of  consumption  on  May  10,  1790,  in  his  forty- 
second  year.  From  an  obituary  in  the  Connecticut  Journal,  we 
read: 

He  sustained  an  irreproachable  character  through  life,  and  died 
universally  lamented  by  his  acquaintances.  Reading  and  reflection  had 
furnished  him  with  an  unusual  portion  of  useful  knowledge,  and  those 

1  Vol.  1. 

432 


HEZEKIAH  BEARDSLEY  433 

who  knew  him  best  always  admired  that  firmness,  accuracy  and  strength 
of  mind,  which  rendered  him  one  of  the  most  independent  of  men.2 

At  the  instance  of  Sir  William  Osier,  the  description  of  Heze- 
kiah  Beardsley  was  reprinted  in  the  Archives  oj  Pediatrics,3  This 
account  first  appeared  in  the  earliest  volume  of  medical  trans- 
actions issued  in  this  country  entitled  "  Cases  and  Observations, 
by  the  Medical  Society  of  New-Haven  County,  in  the  State  of 
Connecticut."4 

There  can  be  no  question  as  to  the  nature  of  the  condition 
which  Dr.  Beardsley  describes,  but  George  Armstrong  (quern 
vide),  as  Foote  pointed  out,5  recorded  the  first  instance  of  this 
disease  in  medical  literature.  It  is  interesting  in  this  connection 
that  Cautley  and  Dent6  date  the  disease  back  only  to  1841. 

Beardsley  noted  practically  every  feature  of  the  disease  as  we  now 
know.  He  had  attended  the  patient  for  three  years  at  Southington,  and, 
when  her  death  at  the  age  of  five  years  "closed  this  painful  and  melan- 
choly scene,"  he  performed  the  autopsy.  He  speaks  of  the  "constant 
puking,"  which  was  first  noted  during  the  first  week  of  life.  Everything 
in  the  shape  of  food  the  child  took  was  almost  instantaneously  ejected, 
and  very  little  changed.  The  faeces  were  small  in  quantity.  He  comments 
upon  the  leanness  and  wizened  old  look  of  the  child,  and  states  he  had 
"pronounced  a  scirrhosity  in  the  pylorus  months  before  the  child's 
death,"  although  he  first  attributed  the  condition  to  a  deficiency  of  the 
bile  and  gastric  juices,  joined  with  a  morbid  relaxation  of  the  stomach. 
Unfortunately,  Beardsley  did  not  know  of  the  child's  death  "  until  the 
second  day  after  it  took  place.  This  late  period,  the  almost  intolerable 
stench,  and  the  impatience  of  the  people  who  had  collected  for  the 
funeral,  prevented  so  thorough  an  examination  of  the  body  as  might 
otherwise  have  been  made."  At  the  autopsy  Beardsley  noted  that  the 
stomach  was  unusually  large  and  distended.  "The  pylorus  was  invested 
with  a  hard  compact  substance  or  scirrhosity,  which  so  completely 
obstructed  the  passage  into  the  duodenum  as  to  admit  with  the  greatest 
difficulty  the  finest  fluid."  He  concludes,  "The  necessity  of  interring 
the  body  that  evening  put  a  stop  to  any  further  examination,"  and  so 
forbade  a  more  particular  and  accurate  description  of  this  very  "singular 
case."7 

*  Steiner,  W.  R. 

3  Arch.  Pediat.,  N.  Y.,  1903,  xx,  355. 

4  New-Haven,  J.  Meigs,  1788. 

5  Am.  J.  Dis.  Child.,  Chic,  May,  1918. 
8  Lancet,  Dec.  20,   1902. 

7  Steiner,  W.  R. 


CASES  and  OBSERVATIONS; 


BY    THE 


MEDICAL       SOCIETY 


Of  NEW-HAVEN  Coumty,  i»  rnt 


Stat*    of     CONNECTICUT, 


Injlituted  in    the  Tear    ij%4> 


New-Haven  :    Printed  by  J.  Meigs,    1788, 


Title  page  of  the  volume  containing  Beardsley's  account  of  pyloric  stenosis. 


HEZEKIAH  BEARDSLEY  435 

CONGENITAL  HYPERTROPHIC  STENOSIS  OF  THE  PYLORUS 

By  Dr.  Hezekiah  Beardsley 

New  Haven,  Conn. 

A  child  of  Mr.  Joel  Grannis,  a  respectable  farmer  in  the  town  of 
Southington,  in  the  first  week  of  its  infancy,  was  attacked  with  a  puking, 
or  ejection  of  the  milk,  and  of  every  other  substance  it  received  into  its 
stomach  almost  instantaneously,  and  very  little  changed.  The  feces  were 
in  small  quantity  and  of  an  ash  color,  which  continued  with  little  varia- 
tion till  its  death.  For  these  complaints  a  physician  was  consulted,  who 
treated  it  as  a  common  case  arising  from  acidity  in  the  prima  via;  the 
testaceous  powders  and  other  absorbents  and  correctors  of  acid  acrimony 
were  used  for  a  long  time  without  any  apparent  benefit.  The  child, 
notwithstanding  it,  continued  to  eject  whatever  was  received  into  the 
stomach,  yet  seemed  otherwise  pretty  well,  and  increased  in  stature 
nearly  in  the  same  proportion  as  is  common  to  that  state  of  infancy,  but 
more  lean,  with  a  pale  countenance  and  a  loose  and  wrinkled  skin  like 
that  of  old  people.  This,  as  nearly  as  I  can  recollect  at  this  distance  of 
time,  was  his  appearance  and  situation  when  I  was  first  called  to  attend 
him;|he  was  now  about  two  years  old.  I  was  at  first  inclined  to  attribute 
the  disorder  to  a  deficiency  of  the  bile  and  gastric  juices,  so  necessary 
to  digestion  and  chylifi cation,  joined  with  a  morbid  relaxation  of  the 
stomach,  the  action  of  which  seemed  wholly  owing  to  the  weight  and 
pressure  of  its  contents,  as  aliment  taken  in  small  quantities  would  often 
remain  on  it,  till,  by  the  addition  of  fresh  quantities,  the  whole,  or 
nearly  all,  was  ejected;  but  his  thirst,  or  some  other  cause,  most  com- 
monly occasioned  his  swallowing  such  large  draughts  as  to  cause  an 
immediate  ejection,  and  often-times  before  the  cup  was  taken  from  his 
mouth.  It  did  not  appear  that  he  was  attended  with  nausea  or  sickness 
at  his  stomach,  but  he  often  complained  that  he  was  choked,  and  of  his 
own  accord  would  introduce  his  finger  or  the  probang,  so  as  to  excite 
the  heaving  of  the  stomach  and  an  ejection  of  its  contents;  the  use  of 
this  instrument  was  generally  necessary  if  the  stomach  did  not  of  itself, 
in  a  few  moments,  discharge  its  contents,  the  choking  would  in  that  short 
space  of  time  become  almost  intolerable,  which  by  this  discharge  was 
entirely  removed.  In  this  situation,  with  very  little  variation  of  symp- 
toms he  continued  till  death  closed  the  painful  and  melancholy  scene, 
when  he  was  about  five  years  of  age.  He  was  uncommonly  cheerful 
and  active  considering  his  situation.  A  number  of  the  most  respectable 
medical  characters  were  consulted  and  a  variety  of  medicines  was  used 
to  little  or  no  effect.  His  death,  though  long  expected,  was  sudden,  which 
I  did  not  learn  till  the  second  day  after  it  took  place.  This  late  period, 
the  almost  intolerable  stench,  and  the  impatience  of  the  people  who  had 


436  PEDIATRICS  OF  THE  PAST 

collected  for  the  funeral  prevented  so  thorough  an  examination  of  the 
body,  as  might  otherwise  have  been  made.  On  opening  the  thorax,  the 
esophagus  was  found  greatly  distended  beyond  its  usual  dimensions  in 
such  young  subjects;  from  one  end  to  the  other  of  this  tube,  between  the 
circular  fibres  which  compose  the  middle  coat,  were  small  vesicles,  some 
of  which  contained  a  tablespoonful  of  a  thin  fluidlike  water,  and  seemed 
capable  of  holding  much  more.  I  next  examined  the  stomach,  which 
was  unusually  large,  the  coats  were  about  the  thickness  of  a  hog's 
bladder  when  fresh  and  distended  with  air;  it  contained  about  a  wine 
pint  of  fluid  exactly  resembling  that  found  in  the  vesicles  before  men- 
tioned, and  which  I  supposed  to  have  been  received  just  before  his 
death.  The  pylorus  was  invested  with  a  hard  compact  substance,  or 
schirrosity,  which  so  completely  obstructed  the  passage  into  the  duo- 
denum, as  to  admit  with  the  greatest  difficulty  the  finest  fluid;  whether 
this  was  the  original  disorder,  or  only  a  consequence,  may  perhaps  be  a 
question.  In  justice  to  myself  I  ought  to  mention,  that  I  had  pronounced 
a  schirrosity  in  that  part  for  months  before  the  child's  death.  On  remov- 
ing the  integuments  of  the  abdomen,  I  was  struck  with  the  appearance  of 
the  vesica  fellis,  which  was  nearly  five  inches  in  length  and  more  than 
one  in  diameter;  it  lay  transversely  across  the  abdomen,  and  was 
bedded  into  the  small  intestines,  which  were  sphacelated  wherever  they 
came  in  contact  with  it;  its  contents  were  rather  solid  than  fluid,  and 
resembled  flesh  in  a  highly  putrid  state;  its  color  was  that  of  a  very  dark 
green,  like  the  juice  of  the  night-shade  berry,  and  a  fluid  of  the  same 
color  exuded  through  its  sphacelated  coats.  The  necessity  there  was  of 
interring  the  body  that  evening,  put  a  stop  to  any  further  examination. 
I  should  have  been  happy,  gentlemen,  if  I  had  been  able  to  have  given 
you  a  more  particular  and  accurate  description  of  this  very  singular 
case,  but  the  above  mentioned  circumstances  forbade. 


Samuel  Thomas  Soemmering 
[  1 755-1 830] 


SAMUEL  THOMAS  SOEMMERING 

[  1 755-1 830] 

IF  you  turn  to  the  Journal  Hebdomadaire  de  Medecine  for 
the  first  of  May,  1830,  you  will  find  an  account  of  this'extraor- 
dinary  investigator  which  was  used  as  a  basis  for  a  notice  in 
the  Lancet  of  May  15,  1830.  Here  we  learn  that  Samuel  Thomas 
von  Soemmering  was  born  at  Thorn,  January  25,  1755.  He 
received  his  doctor's  degree  at  Gottingen  on  April  7,  1778.  His 
inaugural  dissertation  entitled:  "Dissertatio  de  basi  encephali 
et  originibus  nervorum,  cranio  egredientium,,,  was  the  beginning 
of  a  remarkable  series  of  contributions  and  was  rapidly  followed 
by  a  study  of  the  structure  of  the  lymphatic  system  and  the 
changes  which  occur  in  it  in  disease.  As  a  result  of  the  interest 
taken  in  the  race  question  he  published  in  1784  a  treatise  on  the 
racial  difference  between  the  blacks  and  the  Europeans  and  in 
the  same  year  he  brought  out  his  study  on  the  calculi  of  the 
pineal  gland.  In  1786  there  appeared  his  work  on  the  crossing 
of  the  optic  nerves  and  two  years  later  a  volume  on  the  brain  and 
spinal  cord,  two  years  after  that  his  study  on  the  pernicious 
effects  of  corsets.  Up  to  this  time  his  work  had  scarcely  attracted 
the  attention  of  the  scientists,  but  when  he  spoke  on  corsets  all 
Europe  listened.  His  next  work  is  the  one  of  pediatric  interest. 
It  came  out  in  1791  and  is  entitled:  "Abbildungen  und  Be- 
schreibungen  einiger  Misgeburten,  die  sich  ehemals  auf  dem  anato- 
mischen  Theater  zu  Cassel  befanden.,,  This  contains  the  plate 
showing  an  example  of  achondroplasia  or  chondrodystrophy. 
There  followed  rapidly  works  on  the  cure  of  calculi  (1791),  with 
J.  Wenzel  on  the  changes  in  the  bones  in  gout  (1795).  His  five- 
volume  work  on  anatomy,  "  Vom  Bau  des  menschlichen  Korpers," 
was  a  great  success  and  went  through  several  editions.  He  wrote 
about  the  seat  of  the  soul  but  added  nothing  new  to  this  subject. 
Of  rare  excellence  are  his  "Tabulae  baseos  encephali, "  showing 
the  differences  between  the  brains  of  man  and  animals.  In  1801 
he  published  his  "Icones  herniarum.,,  Of  greatest  importance 

437 


Soemmering's  plate  showing  a  case  of  achondroplasia. 


SAMUEL  THOMAS  SOEMMERING  439 

are  his  contributions  to  the  organs  of  the  senses,  four  volumes  in 
Latin  subsequently  translated  into  German  and  published  in 
one  volume.  This  is  not  all,  but  omitting  the  others  mention  must 
be  made  of  what  is  regarded  as  his  masterpiece,  "  Icones  embry- 
onum  humanorum."  This  served  to  awaken  an  interest  in  embry- 
ology and  it  was  followed  by  the  brilliant  researches  of  Michel, 
Burdach,  Tiedemann,  Carus  and  others. 

In  1828  on  the  fiftieth  anniversary  of  the  doctorate  of  this 
venerable  scientist,  there  was  a  formal  meeting  at  which  the 
greatest  workers  of  the  day  paid  homage  to  the  father  of  embry- 
ology. It  should  not  be  forgotten  that  Soemmering  in  1809 
demonstrated  a  primitive  apparatus  for  electric  telegraphy. 

Taken  all  in  all,  Soemmering  was  one  of  the  brightest  lights 
of  his  century,  an  inspiration  to  all  scientific  workers. 

Soemmering's  description  of  achondroplasia  is  limited  to 
the  description  of  his  plate  illustrating  "a  child  from  the 
Koltschmieden  collection  which  presented  a  very  remarkable 
appearance." 

"  It  is  of  female  sex,  and  weight  three  pounds  and  six  ounces. 
It  is  very  fat  and  round;  but  the  upper  and  lower  extremities 
are  much  too  short."  Then  follows  a  list  of  measurements  which 
need  not  be  given  here.  In  this,  as  in  many  instances  of  early  or 
first  descriptions,  the  account  is  short  but  convincingly  clear. 
(See  illustration.) 


GEORGE  ARMSTRONG 

[?-i764] 

GEORGE  ARMSTRONG,  one  of  the  best  of  the  earliest 
British  pediatrists,  was  the  brother  of  John  Armstrong,  the 
poet.  Judging  from  his  career,  he  was  evidently  endowed 
with  the  same  curious  personality  that  so  handicapped  the  phy- 
sician-poet brother.  Little  is  known  about  him  except  that  he  first 
practiced  pharmacy  in  Hempstead,  then  qualifying  as  a  physician 
he  removed  to  London.  There  he  established  the  first  hospital  and 
dispensary  for  the  children  of  the  poor,  which  ran  until  December, 
1 78 1,  when  it  was  closed  for  lack  of  funds.  It  has  been  estimated 
that  over  35,000  children  were  treated  at  the  hospital  during  this 
period. 

Here  he  had  rare  opportunity  for  clinical  observation  and 
post-mortem  investigation,  the  results  of  his  painstaking  studies 
being  printed  in  the  later  editions  of  his  work  on  children,  origi- 
nally issued  in  1767  with  the  title  of  an  "Essay  on  the  Diseases 
Most  Fatal  to  Infants  to  Which  Are  Added  Rules  to  be  Observed 
in  the  Nursing  of  Children,  with  a  Particular  View  to  Those  Who 
Are  Brought  Up  by  Hand."  This  was  reprinted  with  additions  in 
1 77 1.  In  1777  there  appeared  "An  Account  of  the  Diseases  Most 
Incident  to  Children  From  Their  Birth  to  the  Age  of  Puberty." 
This  was  reprinted  in  1783,  and  a  subsequent  edition  was  edited  by 
A.  P.  Buchan  in  1808.  This  last  edition  is  somewhat  larger  and 
includes  the  excellent  essay  on  nursing  which  had  been  printed 
in  much  shorter  form  in  1772.  It  also  contains  "A  General  Account 
of  the  Dispensary  for  the  Infant  Poor." 

Armstrong  should  be  one  of  the  patron  saints  of  prophylactic 
pediatrics,  along  with  Pemell  and  Cadogan.  He  dreamed  dreams 
and  saw  visions  far  in  advance  of  his  time.  He  actually  put  the 
products  of  his  imagination  into  practical  form.  But  he  was 
ahead  of  his  age  and  did  not  possess  the  personality  to  impress 
his  ideas  on  the  rich  and  powerful.  He  calls  attention  to  the 
fact  that  at   his  institution  children  were  received   "without 

440 


A  N 

ACCOUNT 

0   F     T   H    E 

DISEASES 

MOST  INCIDENT   TO    CHILDREN. 
FROM  THEIR  BIRTH  TILL  THE  AGE  OF  PUBERTY; 

WITH 

A   SUCCESSFUL   METHOD    OF    TREATING    THEM. 

To  which  is  added, 

An   ESSAY    on    NURSING. 

ALSO 

A   General  Account  of  the   Dispensary   for  the 

Infant  Poor,  from  its  firft  Inftitution  in  1769 

to  the  prefent  Time, 

■     '  ■  ■     ■  ■     ■        1— m^mmmmm — — — — — — — — — » 

By  GEORGE  ARMSTRONG,  M.  D. 

PHYSICIAN   TO    THE    DISPENSARY. 

————————     1   —— — — — ■—— — — mtrmmmm ^— — — — — —  1    1      -^ 

LONDON: 
PRINTED    FOR    T.  CADELL,    IN    THE    STRAND. 
MDCCLXXVII. 

Title  page  of  the  book  of  George  Armstrong. 


442  PEDIATRICS  OF  THE  PAST 

any  letters  of  admission,  provided  the  parents  are  really  indigent, 
the  case  dangerous,  and  requiring  speedy  relief."  He  also  states 
and  truly,  that  "no  charitable  institution  was  ever  established 
whereby  so  much  good  was  done  or  so  many  lives  saved  at  so 
small  expense/' 

This  book  was  dedicated  to  Queen  Charlotte: 

It  would  be  doing  the  greatest  injustice  to  your  Majesty's  humanity 
and  benevolence,  to  suppose  that  the  welfare  of  the  Infant-race  can  be 
indifferent  to  your  Majesty.  A  full  assurance  of  the  contrary  has  induced 
me  to  solicit  the  honor  of  your  Royal  patronage  to  the  following  work, 
of  which  the  chief  intention  is  to  alleviate  the  distresses  incident  to 
children,  from  the  various  diseases  to  which  they  are  exposed.  This  is  a 
field  that  stands  greatly  in  need  of  cultivation;  and  your  Majesty's 
gracious  countenance  to  an  attempt  of  this  kind,  cannot  fail  to  have  a 
happy  effect  in  inciting  others  to  make  further  improvements  on  it. 

There  is  no  record  that  the  Queen  did  anything  to  help  his 
hospital,  for  a  few  years  later  it  was  closed. 

The  book  is  a  duodecimo  of  some  175  pages,  with  interesting 
chapters  on  inward  fits,  thrush,  watery  gripes,  convulsions  and 
hydrocephalus  internus,  of  which  he  thought  he  had  a  cure, 
relating  cases  of  his  own  and  one  by  his  friend  John  Hunter.  This 
method  was  purging  with  calomel  and  blistering  the  neck,  a  sug- 
gestion that  Armstrong  had  from  Dr.  Dobson,  of  Bath.  There  are 
a  dozen  other  chapters. 

James  Atkinson,  of  York,  mentions  Armstrong  in  that  most 
remarkable  of  all  works  of  its  kind,  "Medical  Bibliography, 
A.  B.,"  as  follows: 

There  is  considerable  practical  information,  and  much  childishnous 
about  Armstrong.  He  recommends  his  profession  with  warmth,  and 
laments  its  neglect  and  abuse  with  censure.  The  cradle  and  the  nursery 
have  been  much  obliged  to  him;  for  he  who  saves  the  king's  subjects, 
earns  him  a  great  deal  of  money;  and  he  who  preserves  the  life  of  a  child, 
rescues  it  at  least  from  a  very  stupid  sojourn  in  limbo. 

Armstrong's  therapeutics  were,  for  the  most  part,  sound; 
he  inclined  to  antimonial  pukes,  bled  some,  blistered  some,  but 
he  knew  the  value  of  rhubarb,  alkalis,  calomel,  used  "  hydrar gyrus 
cum  creta  in  small  quantities,  if  the  rash  has  a  venereal  appear- 
ance" and  was  keenly  alive  to  the  danger  of  opium.  He  also 
knew  the  value  of  diet  and  hygienic  measures.  As  Foote  says: 


GEORGE  ARMSTRONG  443 

This  keen  observer,  brilliant  writer  and  pioneer  physician-philan- 
thropist, who  was  blessed  with  the  true  scientific  spirit  and  an  almost 
prophetic  outlook,  died  in  obscurity,  unpraised  and  unrewarded  except- 
ing in  the  grateful  remembrance  of  the  poor  of  London. 

A  few  examples  of  this  style  will  suffice  to  show  that  he  was 
a  skilful,  understanding  pediatrist  according  to  the  light  of  his 
day,  indeed  far  ahead  of  his  time. 

The  following  report  of  pyloric  stenosis  in  the  1 777  edition  as 
John  Foote  of  Washington  has  pointed  out,  antedates  Beardsley's 
report.  His  report  of  four  cases,  three  of  which  were  in  one  family, 
with  his  remark  that  "perhaps  cases  of  this  kind  are  more  frequent 
than  is  commonly  supposed,"  proves  that  he  knew  what  he  was 
talking  about. 

When  the  child  comes  to  be  about  five  or  six  months  old,  if  the  milk 
victuals  be  apt  to  grow  sour  upon  its  stomach,  it  will  be  right  to  use 
weak  broth,  either  of  chicken,  veal,  or  mutton,  or  beef  tea,  as  it  is  called, 
instead  of  milk,  in  its  food,  or  at  least  it  may  be  fed  with  this  once  or 
twice  a-day.  A  little  almond  soap  dissolved  in  the  milk,  in  the  manner 
before  directed,  will  for  the  most  part  serve  to  correct  this  acidity. 

About  the  age  of  seven  months,  if  the  child  is  cool,  and  not  inclined 
to  be  fat,  you  may  begin  to  give  it  at  noon,  once  in  two  or  three  days, 
a  very  little  bit  of  the  white  of  the  wing  of  a  boiled  chicken,  minced  very 
small,  and  mixed  up  into  a  kind  of  pap,  with  some  of  the  broth  that  the 
chicken  was  boiled  in,  and  a  good  deal  of  crumb  of  bread.  But  when  it 
is  at  any  time  inclined  to  be  feverish,  it  must  have  nothing  of  this  kind. 

At  this  age,  too,  you  may  begin  to  give  it  a  little  plain  light  bread 
pudding,  now  and  then,  for  dinner. 

About  the  same  age,  or  rather  before,  that  is,  as  soon  as  the  child 
can  hold  any  thing  in  its  hand,  the  nurse  should  every  morning  give  it  a 
piece  of  the  upper  crust  of  a  loaf,  cut  in  the  shape,  and  about  the  size, 
of  a  large  Savoy  biscuit,  one  end  of  it  dipped  in  its  food,  or  a  little  milk, 
and  put  into  its  mouth,  and  the  other  to  be  held  in  its  hand.  The  child 
will  lie  and  divert  itself  with  this,  gnaw  and  swallow  it  by  degrees,  which 
will  not  only  help  to  nourish  it,  but  bring  a  greater  quantity  of  saliva 
into  the  mouth,  whereby  the  gums  will  be  softened,  and  at  the  same  time, 
by  the  gentle  and  repeated  friction,  the  cutting  of  the  teeth  will  be  greatly 
promoted.  For  this  end  likewise,  it  will  be  proper  to  rub  the  child's  gums 
frequently  with  a  little  honey,  or  currant-jelly. 

The  milk  victuals  should  be  made  fresh  twice  a-day,  that  is,  morning 
and  evening  in  winter;  and  three  times  in  summer,  especially  in  hot 
weather;  and  the  milk  must  never  be  boiled  with  the  pap,  but  by  itself, 


444  PEDIATRICS  OF  THE  PAST 

and  added  to  the  pap  every  time  the  child  is  fed;  otherwise  it  will  curdle, 
and  grow  sour  on  the  child's  stomach.  It  can  hardly  be  necessary  to 
mention,  that  when  new  milk  is  made  use  of,  it  must  not  be  boiled  at  all. 

As  to  the  times  of  feeding  infants.  While  they  are  very  young,  there 
can  be  no  regular  times  fixed;  but  the  few  following  general  rules  may 
be  of  service.  During  the  first  few  weeks  that  the  child  sucks,  when  it  is 
not  brought  up  by  hand  from  the  birth,  if  the  mother  has  a  good  deal  of 
milk,  the  infant  will  require  very  little  feeding;  and  that  chiefly  in  the 
night,  in  case  it  should  be  wakeful;  that  the  mother's  rest  may  not  be 
broke  by  suckling  it.  But  when  it  comes  to  be  weaned,  it  must  be  fed 
chiefly  in  the  day-time,  and  put  into  the  habit  of  sleeping  during  the 
night  as  soon  as  possible.  At  first,  it  should  be  fed  frequently,  and  only 
a  little  at  a  time;  for  cramming  can  never  be  of  service,  but  hurtful.  I 
wish  nurses  would  observe  this  more  than  they  commonly  do,  and  make 
it  a  general  rule,  never  to  force  victuals  down  a  child's  throat  when  it 
refuses  them.  I  have  very  often  observed  nurses  guilty  of  this  error,  and 
told  them  the  absurdity  of  it,  sometimes  to  little  purpose.  But  still  it  is  a 
circumstance  very  well  worth  minding;  otherwise  both  the  appetite  and 
digestion  of  the  child  may  in  time  be  much  hurt,  by  the  stomach's 
being  repeatedly  overcharged. 

It  is  a  common  opinion,  that  the  complaints  of  children  are  peculiarly 
difficult  to  treat  on  account  of  the  little  patients  being  unable  to  describe 
their  sensations.  But  persons  actually  occupied  in  the  practice  of  medi- 
cine must  be  aware  that  it  is  often  no  less  difficult  to  sift  the  truth  out 
of  the  figurative  and  theoretical  language  in  which  adults  are  apt  to 
clothe  their  feelings,  that  it  is  to  judge  of  the  unadulterated  expressions 
of  distress,  exhibited  by  an  infant  suffering  from  disease. 

In  a  child  about  three  weeks  old,  that  died  of  the  watery-gripes 
some  time  since,  and  which  I  opened,  I  found  most  of  the  stomach, 
towards  the  upper  orifice,  and  almost  the  whole  fundus,  in  the  same 
tender  state  with  that  of  the  child  just  now  mentioned.  But  towards 
the  pylorus,  the  structure  was  firm  enough,  as  likewise  that  of  the  intes- 
tines, both  small  and  great.  The  stomach  was  quite  distended  with 
curdled  milk  and  victuals,  with  which  the  nurse  had  crammed  the  child, 
mixed  likewise  with  some  of  the  chalk  julep,  but  the  whole  intestines 
were  remarkably  empty.  There  was  no  morbid  appearances  to  be 
observed  any  where  but  in  the  stomach;  and  this  viscus  being  so  full, 
while  the  intestines  were  almost  empty,  it  looked  as  if  the  disease  had 
been  chiefly  owing  to  a  spasm  in  the  pylorus,  which  prevented  the  con- 
tents of  the  stomach  from  passing  into  the  duodenum.  Perhaps,  cases  of 
this  kind  are  more  frequent  than  is  commonly  imagined;  and  it  might 
probably  be  owing  to  the  tender  state  of  the  stomach,  that  the  antimonial 
solution,  which  was  given  the  child,  had  but  very  little  effect;  and  I 


GEORGE  ARMSTRONG  445 

have  commonly  observed,  that  when  vomiting  or  purging  medicines, 
given  to  infants  in  a  sufficient  quantity,  have  not  the  usual  effect,  it  is 
a  very  bad  sign.  What  is  remarkable,  this  was  the  third  child  (and  they 
have  never  had  any  more)  which  the  parents  have  lost  at  the  same  age, 
and  in  the  same  disease. 

But  though,  as  I  just  now  observed,  I  do  not  advise  dry-nursing  of 
infants,  when  they  can  be  properly  suckled,  yet  I  would  not  have  parents 
to  be  discouraged  from  trying  it  when  it  becomes  requisite,  being  firmly 
persuaded,  that  if  a  child  is  born  pretty  strong  and  healthy,  it  had  better 
be  brought  up  by  hand,  in  the  method  to  be  afterwards  explained,  than 
suckled  by  an  ailing  nurse,  or  one  that  has  not  a  sufficient  quantity  of 
milk.  For,  when  I  talk  of  a  child's  being  properly  suckled,  I  mean  by 
a  nurse  who  is  healthy,  sober,  good-tempered,  cleanly,  careful,  and  has 
plenty  of  good  milk.  A  wet-nurse  ought  likewise  to  have  pretty  strong 
nerves;  for  if  they  are  weak,  the  least  surprise  has  a  bad  effect  upon  the 
milk;  or  if  the  child  happens  to  be  suddenly  taken  ill,  from  the  fright 
and  anxiety,  the  milk  is  sometimes  quickly  dried  up,  when,  perhaps,  the 
poor  infant  has  the  most  occasion  for  it.  For  this  reason,  some  mothers, 
who  are  very  fond  of  their  children,  make  but  bad  wet-nurses,  though 
well  enough  qualified  for  it  in  other  respects. 

There  are  two  ways  of  feeding  children  who  are  bred  up  by  hand; 
the  one  is  by  means  of  a  horn,  and  the  other  is  with  a  boat  or  spoon. 
They  both  have  their  advocates;  but  the  latter,  in  my  humble  opinion, 
is  preferable. 

The  horn  made  use  of  for  suckling,  is  a  small  polished  cow's  horn, 
which  will  hold  about  a  gill  and  a  half.  The  small  end  of  it  is  perforated, 
and  has  a  notch  round  it,  to  which  are  fastened  two  small  bits  of  parch- 
ment, shaped  like  the  tip  of  the  finger  of  a  glove,  and  sewed  together  in 
such  a  manner,  as  that  the  food  poured  into  the  horn  can  be  sucked 
through  between  the  stitches.  This  appears  to  be  a  very  simple  and 
ingenious  contrivance,  and  is  admired  by  some,  who  look  upon  it  as  a 
kind  of  artificial  nipple;  and  it  might  very  well  be  considered  as  such, 
if  we  had  but  the  breast-milk  to  convey  through  it.  Or  if  we  could  dis- 
cover any  food  of  the  same  thinness  with  the  milk,  and  as  nourishing  as 
it  is,  the  horn  might  still  answer.  But  as  a  discovery  of  this  kind  is  not 
to  be  expected,  and  the  food  which  the  child  sucks  through  this  artificial 
nipple  must  be  thin,  in  order  to  pass  between  the  stitches,  there  requires 
a  larger  quantity  of  it  to  nourish  the  child,  and  hence  its  stomach  and 
bowels  are  too  much  relaxed,  whereby  it  is  in  danger  of  falling  into  the 
watery  gripes,  as  was  the  case  with  two  of  mine,  which  were  fed  for  some 
time  in  that  way. 

While  the  child  is  suckled,  I  think  the  best  food  is  crumb  of  bread 
boiled  in  soft  water,  to  the  consistence  of  what  is  commonly  called  pap, 


446  PEDIATRICS  OF  THE  PAST 

or  a  thin  panado.  The  bread  should  not  be  new  baked,  and,  in  general, 
I  think  roll  is  preferable  to  loaf  bread. 

This  pap  should  be  sweetened  with  soft  or  Lisbon  sugar,  unless  the 
child  is  of  a  lax  habit  of  body,  in  which  case  the  finest  loaf  sugar  should 
be  used;  and  in  this  case  too,  the  pap  should  be  made  with  biscuit  instead 
of  roll.  It  should  not  be  made  sweeter  than  new  milk;  for  too  much  sugar 
both  palls  the  appetite,  and  grows  sour  upon  their  stomachs. 

Before  the  child  is  weaned,  the  victuals  should  be  made  thicker,  by 
which  means  it  will  become  less  fond  of  the  breast,  and  consequently, 
as  was  mentioned  above,  easier  to  wean. 

If  the  infant  is  to  be  bred  up  by  hand  from  the  birth,  it  ought  to  have 
new  cow's  milk  mixed  with  its  victuals  as  often  as  possible,  and  now  and 
then  some  of  it  alone  to  drink.  Asses'  milk  will  be  still  better,  when  it 
can  be  conveniently  had,  and  the  parents  can  afford  it. 

But  the  most  useful  exercise  for  very  young  infants,  is  rubbing  with 
the  hand;  which  cannot  be  too  often  repeated,  nor  continued  too  long 
at  a  time.  They  should  be  well  rubbed  all  over,  before  the  fire,  twice  a 
day  at  least,  that  is,  morning  and  evening,  when  they  are  dressed  and 
undressed;  and  the  rubbing  should  be  repeated  from  the  loins  down- 
wards, every  time  they  are  turned  dry,  unless  they  have  a  purging,  when 
it  might  fatigue  them  too  much  to  have  it  done  so  often.  There  is  nothing 
that  infants  in  general  seem  more  delighted  with  than  this  exercise,  and 
it  were  to  be  wished,  that  the  nurses  would  indulge  them  more  in  it.  It 
will  frequently  make  them  quiet  when  nothing  else  will,  and  it  is  not 
only  very  pleasing  to  them,  but  conduces  greatly  to  make  them  thrive, 
and  to  prevent  their  catching  cold,  by  promoting  a  free  circulation,  and 
perspiration  likewise;  Providence  having  kindly  connected  the  agreeable 
sensation  and  the  benefit. 

They  are  particularly  fond  of  cramming  them  with  fat,  from  a 
mistaken  notion,  that  it  must  be  light  of  digestion,  because  it  weighs 
light  in  the  scale;  whereas,  on  the  contrary,  to  most  stomachs,  there  are 
few  things  so  hard  to  be  digested  as  fat. 

Many  poor  children  are  likewise  hurt  by  being  crowded  together 
in  small  close  apartments,  which  is  not  so  easily  remedied;  but  in  this 
case  I  always  advise  them  to  keep  the  windows  open  in  the  day-time, 
while  the  weather  is  hot,  and  the  doors  of  the  bed-chambers  and  closets 
during  the  night.  I  also  object  strongly  to  their  living  in  stable-yards, 
the  air  of  which  is  particularly  unwholesome  to  children,  as  was  before 
mentioned. 


A 


Early  Devices  Used  in  Infant  Nursing.   (Copyright  by  and  reproduced  through  the 
courtesy  of  the  Wellcome  Medical  Historical  Museum.) 


w 


MICHAEL  UNDERWOOD 

[ i 737-1 820] 

HEN  Marshall  Hall  edited  the  ninth  edition  of  Under- 
wood's book  in  1835,  there  was  inserted  "a  short 
account  of  the  author,"  but  whether  this  was  by  Hall  or 

by  Samuel  Merriman,  who  edited  the  eighth  edition  in  1 826,  is  not 

clear.  This  account  starts  off: 

Michael  Underwood  was  born  on  the  29th  of  September,  1737,  of 
respectable  parents,  who  gave  him  a  good  education,  by  putting  him  to 
school,  first  at  West  Moulsey,  and  afterwards  at  Kensington. 

One  wonders  if  some  of  his  peculiarities  were  in-born  or  the 
result  of  the  "good  education. "  However  that  may  be,  he  was 
placed  later  with  Mr.  Caesar  Hawkins  (1711-1786),  a  skilful 
operator  and  sergeant-surgeon  to  King  George  11,  and  eventually 
became  a  house-pupil  in  St.  George's  Hospital.  He  also  came  in 
contact  with  John  Freke  (1688-1756),  a  surgeon  of  the  time  who 
couched  cataract  for  the  poor  at  St.  Bartholomew's,  the  first 
curator  of  the  museum  of  the  Hospital;  a  student  and  experi- 
menter in  the  natural  sciences  who  is  mentioned  twice  in  Field- 
ing's "Tom  Jones:" 

We  wish  Mr.  John  Fr  .  .  .or  some  other  such  philosopher  would 
bestir  himself  a  little  in  order  to  find  out  the  real  cause  of  this  sudden 
transition  from  good  to  bad  fortune.1 

Underwood,  after  a  sojourn  in  Paris,  became  a  member  of  the 
Surgeon's  Company  and  started  out  in  Margaret  Street,  Caven- 
dish Square,  combining  the  practice  of  obstetrics  with  his 
operative  work.  Later,  he  was  appointed  surgeon  to  the  British 
Lying-in  Hospital.  In  1783,  he  published  a  "Treatise  upon 
Ulcers  of  the  Legs,"  to  which  were  appended  some  "Observations 
on  Scrophulous  Tumours"  and  "On  the  Mammary  Abscess  and 
Sore  Nipples  of  Lying-in  Women."  This  went  through  several 
editions. 

1  Fielding,  H.  Tom  Jones,  ed.  1,  p.  74. 

447 


A 

TREATISE 

O   N 

THE  DISEASES  OF  CHILDREN, 

WITH  GENERAL  DIRECTIONS 
r  O  & 

THE  MANAGEMENT  OF  INFANTS 

FROM 

THE    BIRTH. 
By   MICHAEL   UNDERWOOD,   M.  D, 

LICENTIATE  IN  MIDWIFERY 
OP    TUB 

Royal  College  of  Phyficians,  in  London, 

AND 

Phyfician  to  the  Britifh  Lyiug-in  Hofpiul. 

IN      TWO     VOLUMES. 
VOL.    I, 


A  NEW    EDITION,    REVISED  AND   ENLARCED. 

Otnari  Res  ip/a  negat^  content  a  doceru    MANILL. 

'-'  »■■    ■   SSSSSSS£SSSSSSSSSSSSSSSSSSSSSBBBSSSSSBSBSSOi 

LONDON. 

PRINTED  FOR  J.  MATHEWS,  NO.  l8,  STRAND. 
M  DCC   LXXXIX. 

t  Price  Seven  Shillings  fewtd.  ] 


Title  page  of  Underwood's  book. 


MICHAEL  UNDERWOOD  449 

Underwood  was  one  of  the  first  licentiates,  and  lived  to  be 
the  last,  in  midwifery  of  the  Royal  College  of  Physicians  of 
London;  he  received  an  honorary  diploma  constituting  him  a 
doctor  of  medicine,  and  he  was  then  admitted  into  this  class  of 
licentiates,  together  with  other  distinguished  practitioners  of 
midwifery  in  London  in  1784,  the  same  year  that  his  treatise  on 
children  was  first  published.  Eventually,  the  College  of  Phy- 
sicians decided  to  admit  no  more  candidates  to  this  class  of 
practice  and  for  some  years  Underwood  was  the  only  permissus  ad 
artem  obstetrician  exercendam  of  the  College. 

Underwood  was  a  skilful  accoucheur;  his  clientele  even 
included  persons  of  rank  and  consequence.  Through  the  influence 
of  Dr.  Warren,  he  attended  the  Princess  of  Wales  at  the  time  the 
Princess  Charlotte  was  born.  In  his  day  to  deliver  a  princess  was 
a  greater  thing  than  to  write  the  first  unquestioned  description  of 
poliomyelitis. 

On  the  road  to  wealth  and  position,  he  unfortunately  was 
assailed  by  a  variety  of  domestic  afflictions;  his  naturally  weak 
constitution  was  unable  to  withstand  the  pressure  and  in  1801  he 
retired  from  practice  with  the  idea  of  spending  the  remainder  of 
his  days  in  seclusion.  Happily,  the  cloud  of  melancholy  and 
despondency  which  enveloped  him  was  dispelled  after  some 
years  and  he  resumed  his  practice  to  a  limited  extent.  His  life 
was  "spent  in  tranquility  and  pious  resignation"  until  death 
relieved  him  on  March  4,  1820. 

He  was  never  a  wealthy  man,  indeed  his  friends  came  to  his 
rescue  during  his  dark  years;  when  he  died,  a  widowed  daughter 
was  left  without  sufficient  provision  and  this  lead  to  the  pub- 
lishing by  subscription  in  1824  of  a  selection  of  "Extracts  from 
the  Diary  of  the  Late  Michael  Underwood,  m.  d."  This  volume 
included  "Meditations,  Critical  and  Practical  Remarks  on 
Various  Passages  of  Scripture,  Miscellaneous  Essays,  and  Occa- 
sional Hymns/ '  Our  biographic  notes  are  largely  and  vicariously 
taken  from  a  brief  memoir  which  prefixes  this  volume. 

In  1784,  the  first  edition  of  his  "Treatise  on  the  Diseases 
of  Children"  was  issued  in  one  volume.  In  1789  a  second  two- 
volume  editon  was  printed  and  in  the  subsequent  editions  it  was 
a  three- volume  affair,  though  in  1801  a  one- volume  issue  was  put 
out,  divided  however  into  three  parts:  medical,  surgical  and  the 
care  of  children.  In  18 19  he  revised  the  last  edition  published 


450  PEDIATRICS  OF  THE  PAST 

during  his  life.  In  1826,  Samuel  Merriman  edited  the  eighth 
edition.  This  he  changed  somewhat  in  style,  cutting  out  such 
numerous  expressions  as  "it  is  apprehended,"  "as  has  been  said," 
"as  hinted,"  "as  noticed";  also  such  redundancies  as  the  infant's 
"little"  mouth,  "little"  smiles,  "little"  tears,  "little"  bowels 
and  the  like.  The  ninth  edition  appeared  in  1835,  with  notes  by 
Marshall  Hall,  of  reflex  action  fame.  The  notes  are  initialed 
and  are  chiefly  of  a  practical  nature. 

The  tenth  and  last  edition  was  put  out  in  1846  under  the 
editorship  of  Henry  Davies,  whose  additions,  marked  by  his 
initials,  are  rarely  of  much  value.  The  original  simplicity  of  the 
book  had  by  now  become  spoiled,  and  the  numerous  interpola- 
tions from  other  authors  detracted  greatly  from  its  value. 

For  over  sixty-two  years,  Underwood's  book  was  the  accepted 
text  in  pediatrics.  A  long  time  for  a  book  to  last.  The  little  book 
of  Walter  Harris  was  published  in  1689  and  lasted  nearly  a 
hundred  years,  when  Underwood's  treatise  supplanted  it.  Apart 
from  Rosen  von  Rosenstein,  of  whose  book  an  English  edition 
appeared  in  1776,  Underwood's  was  the  first  treatise  on  children's 
diseases  anything  like  our  modern  textbooks  in  style  and  quality. 

It  is  a  readable  book,  especially  for  a  pediatrist.  Others  might 
find  it  less  entertaining.  A  few  extracts  will  give  one  an  idea  of 
the  style  and  flavor. 

The  following  account  of  the  diseases  of  children,  which  now  makes 
its  appearance  in  a  somewhat  new  form,  and  less  exceptionable  to 
professional  men,  it  is  hoped  may  place  this  branch  of  medicine  upon  a 
respectable  footing,  and  exhibit  a  practice  as  founded  and  rational  as 
in  any  other.  That  no  such  serious  attempt  has  hitherto  been  made, 
is  sufficiently  acknowledged;  although  detached  parts,  and  some  of  the 
more  important  diseases  of  childhood,  have  been  ably  considered,  at 
different  periods. 

For  the  manner  in  which  the  work  is  now  executed,  the  author  can 

only  say,  that  in  addition  to  a  long  experience,  he  has  carefully  consulted 

the  most  respectable  authorities,  as  well  ancient  as  modern;  while  by  a 

j    close  attention  to  facts,  he  has  endeavoured  to  obviate  the  effects  of  that 

peculiar  veil  which  is  said  to  obscure  infantile  disorders. 


The  following  quotation  is  a  notable  one,  as  it  is  the  first 
clear  description  of  poliomyelitis.  From  the  present  time  back 
to  this  description  of  Underwood's,  which  is  quoted  from  one  of 
the    later    editions,  the  history  of  the  disease  may  be  traced 


MICHAEL  UNDERWOOD  451 

with  ease.  When  we  pass  to  times  earlier  than  Underwood's, 
we  go  into  rather  uncertain  territory  in  which  the  diseases 
which  may  have  been  poliomyelitis  are  more  or  less  mixed  with 
other  conditions,  such  as  various  forms  of  encephalitis  and  cases 
of  food  poisoning.  An  attempt  has  also  been  made  to  solve  the 
problem  of  these  early  descriptions  by  seeing  in  them  nervous 
manifestations  of  influenza.  Whether  one  agrees  with  this  sugges- 
tion or  not,  the  fact  remains  that  it  is  interesting  and  notable.  In 
our  extract  it  is  curious  to  note  Samuel  Merriman's  bracketed 
comment  on  "irons  to  the  legs." 

Debility  of  the  Lower  Extremities.  This  disorder  either  is  not  noticed 
by  any  medical  writer  within  the  compass  of  my  reading,  or  is  not  so 
described  as  to  ascertain  the  disease  here  intended.  It  is  not  a  common 
disorder  anywhere,  I  believe,  and  seems  to  occur  seldomer  in  London 
than  in  other  parts  of  the  kingdom.  Nor  am  I  enough  acquainted  with  it 
to  be  fully  satisfied,  either  in  regard  to  the  true  cause,  or  seat  of  the  dis- 
ease, either  from  my  own  observation,  or  that  of  others,  with  whom  I 
have  corresponded,  except  in  the  instance  of  teething  or  of  foul  bowels; 
and  I  have  not  myself  had  an  opportunity  of  examining  the  body  of  any 
child  who  has  died  of  this  complaint.  I  shall  therefore  only  describe  its 
symptoms,  and  mention  the  several  means  attempted  for  its  cure  in 
order  to  induce  other  practitioners  to  pay  attention  to  it. 

If  it  arises  from  teething,  or  foul  bowels,  the  usual  remedies  should 
be  employed;  and  have  always  effected  a  cure.  But  the  complaint  as 
often  seems  to  rise  from  debility,  and  usually  attacks  children  previously 
reduced  by  fever,  seldom  those  under  one  or  more  than  four  or  five  years 
old.  It  is  then  a  chronical  complaint,  and  not  attended  with  any  affection 
of  the  urinary  bladder,  nor  with  pain,  fever,  or  any  manifest  disease; 
so  that  the  first  thing  observed  is  a  debility  of  the  lower  extremities, 
which  gradually  become  more  infirm,  and  after  a  few  weeks  are  unable 
to  support  the  body. 

When  only  one  of  the  lower  extremities  has  been  affected  the  above 
means  in  two  instances  out  of  five  or  six  entirely  removed  the  complaint; 
but  when  both  have  been  paralytic,  nothing  has  seemed  to  do  any  good 
but  irons  to  the  legs,  for  the  support  of  the  limbs,  and  enabling  the 
patient  to  walk.  (It  may  be  doubted  whether  irons  to  the  legs  can  ever 
be  useful  in  a  state  of  paralysis  of  the  lower  extremities.  If  the  limbs  are 
paralytic,  how  are  irons  to  the  legs  to  enable  the  patient  to  walk?  S.  M.) 
At  the  end  of  four  or  five  years,  some  have  by  this  means  got  better 
proportion  as  they  have  acquired  general  strength:  but  even  some  of 
these  have  been  disposed  to  fall  afterward  into  pulmonary  consumption, 
where  the  debility  has  not  been  entirely  removed. 


452  PEDIATRICS  OF  THE  PAST 

There  is  also  a  quotation  from  an  American  in  whom  the 
writer  has  a  peculiar  interest: 

Some  years  ago,  Dr.  John  Archer,  of  Harford  county,  Maryland,  in 
America,  strongly  recommended  the  seneka-root,  (Poly gala  Senega. 
Linn.)  as  an  almost  infallible  remedy  in  this  disease.  I  shall  therefore 
present  the  reader  with  the  doctor's  account  in  his  own  words,  in  a  letter 
he  wrote  to  Dr.  Barton,  of  Pennsylvania  College. 

"  I  have  in  a  great  many  instances  found  a  decoction  of  the  Seneka 
the  most  powerful  medicine  in  the  cure  of  this  disease,  and  I  am  happy 
to  tell  you,  that  I  believe  it  may  be  depended  on.  I  make  a  strong 
decoction  of  the  root  in  the  following  manner,  viz.  half  an  ounce  of  the 
seneka  in  coarse  powder,  is  boiled  in  eight  ounces  of  water,  down  to 
four.  Of  this  I  give  a  tea-spoonful  every  half  hour,  or  hour,  as  the  urgency 
of  the  symptoms  may  require;  and  at  intervals  a  few  drops,  to  keep  up 
the  stimulus,  until  it  either  acts  as  an  emetic  or  cathartic.  I  then  repeat 
it,  in  smaller  quantities,  so  as  to  preserve  the  stimulus  of  the  seneka 
constantly  in  the  mouth  and  throat." 

The  Dr.  Archer  referred  to  was  one  of  the  founders  and  the 
first  president  of  the  Medical  and  Chirurgical  Faculty  of  Mary- 
land; his  inaugural  dissertation,  on  the  subject  of  croup  and 
its  treatment,  contains  the  above  quotation. 

Anyone  who  has  practiced  pediatrics  has  come  up  with  several 
expressions  used  to  designate  such  medical  concepts  as  arise  in 
the  lay  mind.  Such  expressions  as  "liver-grown"  come  in  this 
class.  It  is  with  considerable  pleasure  that  one  finds  that  Under- 
wood has  made  a  comment  on  "inward  fits.'' 

Indeed,  I  know  of  no  complaint  that  ought  to  be  termed  inward-fits; 
and  I  mention  this,  because  nurses  are  continually  talking  to  us  about 
them,  when  children  are  perfectly  well,  and  often  give  the  fond  parent 
needless  distress,  as  well  as  many  an  unpleasant  medicine  to  the  child. 

INCUBUS,   OR   NIGHT-MARE 

It  will  be  sufficient  barely  to  notice  this  affection,  children  either  out- 
growing the  complaint  altogether,  or  any  occasional  return  of  it,  when 
older,  being  esteemed  rather  as  constituting  an  unpleasant  moment, 
than  a  disease  requiring  medical  treatment. 

The  incubus,  probably,  arises  from  a  spasmodic  constriction  of  the 
diaphragm  and  muscles  of  the  chest,  taking  place  during  sleep,  and 
occasions  a  sense  and  dread  of  suffocation,  and  of  some  huge  weight 
lying  across  the  breast.  When  children,  who  happen  to  sleep  with  a  bed- 


MICHAEL  UNDERWOOD  453 

fellow,  awake  under  the  paroxysm,  they  are  wont  to  say  that  their 
companion  has  Iain  with  all  his  weight  for  a  long  time  across  them. 

The  cause  of  this  complaint  seems  to  be  flatulence  in  the  stomach, 
and  indigestion,  and  it  chiefly  attacks  children  or  young  people  of  a 
delicate  habit,  and  such  as  eat  too  freely  of  fruits,  and  especially  such  as 
are  unripe,  or  who  are  in  the  habit  of  eating  much  supper,  a  short  time 
before  going  to  rest. 

The  paroxysms  are  of  different  duration,  some  children  lying  a  much 
longer  time  in  this  unpleasant  state  than  others;  but  in  all,  some  degree 
of  palpitation  of  the  heart,  lightness  of  the  head,  tremor,  anxiety,  or 
lassitude,  remains  for  some  time  afterwards. 

The  curative  indications  are  to  rouse  and  fortify.  During  the  fit, 
.volatiles  and  fetids  may  be  applied  to  the  nostrils;  and,  as  soon  as  may 
be,  some  antispasmodic  should  be  administered  internally.  Afterwards, 
clysters,  bitter  purges,  or  emetics  should  be  exhibited,  as  the  state  of  the 
first  passages  may  indicate,  and  the  cordial  volatile  medicines  be  con- 
tinued. To  these  should  be  added  proper  stomachics,  assisted  by  a 
nutritious  diet  of  easy  digestion,  and  cold  bathing,  if  not  otherwise 
improper. 


SAMUEL  BARD 

[1742-1821] 

THAT  the  revocation  of  the  Edict  of  Nantes  had  a  remark- 
able influence  on  American  medicine  seems  a  strange  state- 
ment, but  it  is  true.  The  persecuted  Protestant  families 
who  preferred  their  faith  to  their  country  left  France,  and  among 
the  exiles  was  Peter  Bard,  whose  son  John  was  the  father  of 
Samuel.  On  the  maternal  side  Peter  Falconier,  surveyor-general 
of  the  province  of  New  York,  was  also  of  French  extraction.  John 
Bard  was  a  successful,  pious  practioner  in  Philadelphia;  he  had 
piety  of  the  same  kind  that  stamped  the  Heberdens,  father  and 
son,  and  no  little  of  it  descended  to  his  son  Samuel,  who  was  born 
on  April  1,  1742.  Four  years  later  the  elder  Bard  removed  to 
New  York  where  the  son  was  educated.  He  was  accounted  "as 
a  quick,  industrious  and  amiable  child,"  and  the  Rev.  John 
McVickar,  his  biographer,  in  his  "Domestic  Narrative  of  the  Life 
of  Samuel  Bard,  m.  d.,  ll.  d.,  recounts  how  the  observant  mother 
wrote  to  the  school  teacher:  "If  Peter  does  not  know  his  lessons 
excuse  him — if  Sam,  punish  him  for  he  can  learn  well."  He  also 
tells  how,  when  Sam  shielded  a  servant  boy  of  about  his  own  age 
by  taking  the  blame  for  his  father's  broken  cane,  his  father 
"praised  his  generosity  but  punished  his  falsehood."  Bard  related 
this  seventy  years  later  and  his  code  was  "Any  fault  may  be 
excused  but  want  of  truth." 

His  education  continued  at  King's  College,  and  at  the  age  of 
nineteen  he  set  out  for  Europe.  On  the  voyage  he  was  captured  by 
the  French,  robbed  and  thrown  into  prison,  from  which  he  was 
eventually  freed  through  the  influence  of  Benjamin  Franklin,  a 
friend  of  the  father.  Thence  to  London  in  1762,  where  Fothergill 
acting  as  his  adviser,  he  writes  home  that  he  is  "growing  familiar 
with  the  Scotch  pronunciation  of  Latin."  He  met  Hunter,  Smith, 
the  surgeon  of  St.  Thomas',  and  Mackenzie.  He  attended  the 
operations  at  St.  Thomas'  and  Guys'  and  read  medicine  in  such 
books  as  Lewis'  "Materia  Medica,"  Sydenham,  Huxham  and 

454 


Samuel  Bard 
[ i 742-1 821] 


E  N   0    U  I  R   Y 

INTO     THE 

NATURE,  CAUSE  andCURE, 

OF    THE 

Angina  Suffocativa, 

O    R,, 
SORE  THROAT   DISTEMPER, 

As  it  is  commonly  called  by  the  Inhabitants  of  this  City 
ancLCoIony. 


By  SAMUEL  BARD,    M.  D. 

And  Professor  of  Medicine  in  King's  Collbge, 

NEW.YORK, 


Is   RECTE   CURATURUS  QUEM   PRIMA  ORIGO  CAUSAE  NON 
FEFELLERIT.  CELSUS. 


N  E  W-Y  ORK: 

Printed  by  S.  Inslee,   and  A,  Car,  at  the  New 
Printing-Oflice  in  Beaver-Street. 

M,DCC,LXXI. 


Title  page  of  Samuel  Bard's  work  on  diphtheria. 


456  PEDIATRICS  OF  THE  PAST 

Smellie.  One  never  sees  Smellie's  name  without  recalling  the 
mistake  he  made  that  got  him  into  "Tristram  Shandy"  as 
"Adrianus  Smelvgot."  A  mistake  pointed  out  by  Dr.  John 
Burton,  of  York,  the  original  of  Dr.  Slop,  to  wit,  that  Litbopaedii 
Senonensis  Icon  was  not  the  name  of  an  author,  but  the  heading 
of  a  drawing  of  a  petrified  fetus. 

Among  Bard's  associates  were  Given,  the  translator  of  Celsus, 
Else,  the  author  of  a  work  on  hydroceles,  and  the  poet  Akenside. 
September,  1762,  found  him  in  Edinburgh,  studying  chemistry 
under  CuIIen,  anatomy  under  Monro  and  physics  under  Ferguson. 
His  account  of  his  day  while  a  student,  is  interesting. 

My  day,  in  general,  is  thus  spent:  from  seven  to  half  past  ten  I  am 
at  present  employed  in  mathematics,  which  will  soon  be  changed  for 
professional  reading  and  the  examination  of  my  notes;  I  then  dress 
and  by  eleven  am  at  college,  attending  professor  Ferguson  until  twelve; 
from  that  hour  until  one  at  the  hospital;  from  one  till  two  with  Dr. 
Culien;  from  two  to  three  I  allow  to  dinner;  from  three  to  four  with 
Monro  in  anatomy;  from  four  to  five,  or  half  an  hour  after,  I  generally 
spend  at  my  flute  and  taking  tea,  either  in  a  friend's  room,  or  with  a 
friend  in  my  own :  after  this  I  retire  to  my  study,  and  spend  from  that 
time  to  eleven  o'clock,  in  connecting  my  notes  and  in  general  reading. 

He  speaks  of  Shippen  opening  his  anatomical  class  and  the 
project  of  a  medical  school  for  Philadelphia.  "I  wish,  with  all 
my  heart,  they  were  at  New  York,  that  I  might  have  a  share 
amongst  them,  and  assist  in  founding  the  first  medical  college 
in  America." 

Bard,  through  various  letters  of  introduction,  was  on  familiar 
terms  with  the  prominent  men  of  Edinburgh.  He  speaks  of  break- 
fasting at  the  Lord  Provost's  and  of  great  intimacy  with  Hope 
and  Monro.  He  was  admitted  as  a  member  of  the  Medical  Society 
and  read  papers  at  various  times,  which  were  styled  in  their 
dismissory  letter  as  plurima  eademque  pulcberrima.  In  1764, 
besides  his  college  duties,  he  had  two  private  tutors  in  writing 
and  speaking  Latin  and  French,  besides  spending  three  hours  a 
week  in  drawing.  His  diligence  won  him  the  Hope  medal,  which 
was  publicly  presented.  He  received  his  degree  on  May  13,  1765, 
"with  all  the  form  and  ceremony  usual  upon  such  occasions.  .  .  . 
My  good  friend,  Dr.  Hope,  publicly  impugned  my  Thesis;  and 


SAMUEL  BARD  457 

to  all  of  them  I  considered  myself  much  indebted,  for  their 
behavior  on  this  occasion,  in  which  although  they  kept  up  the 
strictness  of  professors,  they  never  lost  sight  of  the  politeness  of 
gentlemen.' '  The  examinations  and  ceremonies  were  conducted 
solely  in  Latin.  His  thesis  was  entitled  "De  veribus  opii,"  and 
was  of  sufficient  merit  to  attract  the  attention  of  Haller.  It 
was  an  account  of  the  effect  of  opium  as  noted  in  experiments  on 
his  roommate.  When  Bard  subsequently  reciprocated  as  the 
subject  of  experiments  with  ammonia  he  was  reduced  to  "a 
state  of  torpor  which  continued  several  hours."  Bard's  diploma 
bears  the  date  of  September  6,  1765,  and  has  the  signatures  affixed 
of  the  two  Robertsons,  Rutherford,  the  two  Monros,  Whytt, 
Hope,  Young,  Hamilton,  Cumming,  Ferguson,  Russill  and 
Blair.  His  private  instructor  was  John  Brown,  whom  he  describes 
as  "learned  and  ingenious,  but  at  the  same  time  bold  and  dog- 
matic.''  He  justified  it,  becoming  later  the  author  of  the  theory 
which  bears  his  name. 

The  following  winter  was  spent  in  London,  but  when  spring 
came,  Bard  turned  his  footsteps  into  rural  England  and  then,  for 
some  unknown  reason,  abandoning  a  trip  to  the  Continent, 
he  returned  to  New  York.  Fothergill  gave  him  much  advice, 
concluding  with  what  he  termed  the  secret  of  his  own  success: 
"  I  crept  over  the  backs  of  the  poor  into  the  pockets  of  the  rich." 

On  his  return  to  New  York,  Bard  entered  into  partnership  with 
his  father  and  later  married  his  beautiful  cousin,  Mary  Bard. 
Within  a  year  after  his  return,  he  had  organized  a  medical  school 
and  it  was  united  to  King's  College.  His  associates'  names  convey 
but  little  to  the  average  reader:  Clossy,  Jones,  Middleton,  Smith 
and  Tennent.  Bard,  although  only  twenty-eight,  was  given 
the  department  of  the  practice  of  physic,  which  he  continued  to 
serve  for  forty  years.  The  last  twenty  years  of  his  life  in  the 
city  he  was  trustee  and  dean  of  the  Faculty  of  Physic.  This 
school  conferred  its  first  degrees  in  1769,  on  which  occasion  Bard 
delivered  the  address  to  the  students:  "A  Discourse  upon  the 
Duties  of  the  Physician."  It  was  a  plea  for  the  establishment 
of  a  public  hospital,  and  at  the  dinner  that  followed  he  passed 
around  a  subscription  list  which  Sir  Henry  Moore,  governor  of  the 
province,  headed  with  two  hundred  pounds.  With  the  money  so 
collected,  ground  was  purchased  and  a  building  erected,  but  just 
as  it  was  completed  it  caught  fire  and  was  totally  destroyed. 


458  PEDIATRICS  OF  THE  PAST 

Political  dissentions  and  lack  of  funds  postponed  the  rebuilding 
until  1 79 1.  After  its  completion  Bard  was  a  faithful  attendant, 
never  missing  a  day. 

Another  feature  of  the  " Discourse* '  was  the  exposition  of 
the  practice  then  in  vogue,  of  only  charging  for  the  medicines 
furnished.  Wonderful  prices  medicines  brought  in  those  days, 
which  often  led  to  needless  and  often  hurtful  prescriptions! 

In  1772,  the  joint  practice  of  father  and  son  did  not  seem 
sufficient  to  maintain  two  establishments;  his  biographer  states 
"that  the  cost  of  living  was  much  increased,"  so  it  was  proposed 
that  either  father  or  son  leave  the  city  and  the  elder  as  he  had 
contemplated  leaving,  built  a  country  residence  at  Hyde  Park. 
In  1773  Bard  was  one  of  the  founders  of  a  literary  club  "which 
like  those  of  modern  days,  mixed  up  a  little  literature  with  a 
great  deal  of  conviviality."  Bacchus  had  not  yet  been  banned. 

The  war  brought  its  tribulations.  The  family  was  sent  to 
Hyde  Park  and  subsequently  Bard  left  New  York  just  before 
Howe  entered.  When  he  returned  he  found  his  situation  difficult, 
but  the  kindly  assistance  of  the  mayor  succeeded  in  averting  the 
consequences  of  suspicion  and  his  practice  began  to  grow  again. 
After  the  war  was  over  his  friends  advised  him  to  leave,  but  he 
refused,  and  wisely,  as  Washington  chose  him  for  his  physician. 

Four  of  his  six  children  died  of  malignant  scarlet  fever  and 
their  mother's  mind  became  affected  with  a  melancholy  which 
lasted  about  a  year,  during  which  Bard  was  unremitting  in  his 
care.  A  child  born  subsequently  was  the  delight  of  his  old  age. 

According  to  McVickar,  Bard  attended  Washington  for  a  case 
of  anthrax  and  regarded  the  President  as  his  patron  as  well  as 
patient. 

During  the  war  King's  College  was  converted  into  a  barrack 
and  subsequently  into  a  hospital  for  soldiers,  but  it  was  later 
restored  to  its  former  uses. 

In  1788,  the  doctor's  mob  set  at  defiance  the  civil  and  military 
authorities.  It  grew  out  of  excitement  on  account  of  suspicion 
that  the  physicians  robbed  the  grave  yards.  When  the  mob 
approached  Bard's  house,  the  windows  and  doors  were  thrown 
open  at  his  order,  and  he  paced  the  hall  in  plain  sight.  "His 
calmness  or  his  character  saved  him:  the>  approached  with 
horrible  imprecations;  gazed  a  while  in  silence,  and  then  passed 
on,  with  acclamations  of  his  innocence." 


SAMUEL  BARD  459 

Bard  played  an  important  part  in  the  intellectual  and  philan- 
thropic life  of  the  city.  He  was  one  of  the  founders  and  physicians 
of  the  City  Dispensary.  In  1791,  when  the  Medical  School  was 
reorganized,  he,  the  only  survivor  of  the  originators,  was  made 
dean.  In  1798  he  removed  to  Hyde  Park,  having  previously 
taken  into  partnership  Dr.  David  Hosack.  In  181 3,  when  the 
separation  of  Columbia  College  and  its  medical  school  took  place, 
the  regents  of  the  university  called  Bard  to  the  presidency, 
an  office  which  he  held  until  his  death,  despite  one  effort  on  the 
part  of  some  of  the  faculty  to  get  rid  of  him. 

Bard,  like  his  father,  was  a  Christian  of  the  Heberden  type, 
and  he  was  responsible  for  the  founding  of  St.  James'  (Protestant- 
Episcopal)  Church.  He  wrote  prayers  for  various  occasions  and 
his  letters  are  full  of  pious  sentiments.  It  is  related  that,  like 
the  great  Boerhaave,  he  devoted  part  of  his  early  morning  to 
religious  reading  and  reflection,  a  practice  fallen  into  disuse 
amongst  most  medical  men. 

He  died  of  some  pleuritic  affection  on  May  24,  1821,  twenty- 
four  hours  after  his  wife. 

Like  so  many  other  physicians,  Bard  dabbled  in  verse.  There 
seems  to  be  some  close  association  between  the  poetical  and  the 
medical  mind.  While  it  is  true  that  most  poetry  written  by 
doctors  is  inferior,  there  have  been  many  notable  exceptions. 
One  specimen  of  Bard's  is  preserved  for  us. 

Oh  happiness,  thou  fleeting,  fluttering  thing! 

No  sooner  caught  than,  Io,  thou'rt  on  the  wing! 

Where,  when,  alas!  from  mortals  dost  thou  fly? 

Or  must  we  only  hope  to  hold  thee  when  we  die? 

Yes,  'tis  that  hope  inspires  our  greatest  bliss, 

Supports  in  sorrow,  cheers  us  in  distress; 

Strengthens  our  souls  to  meet  all  ills  below, 

By  hope  of  thee  where  joys  eternal  flow. 

Oh  God,  direct  my  erring  mind  to  things  above, 

Teach  me  to  place  my  bliss  in  faith  and  hope  and  love. 

Bard's  writings  were  rather  numerous  and  included  anni- 
versary discourses  to  medical  students,  public  addresses,  a  volume 
on  obstetrics  written  after  his  retirement,  a  treatise  on  the  use 
of  cold  in  hemorrhage,  and  most  valuable  of  all,  his  little  book, 
"Angina  Suffocativa,"  written  in  1771  after  an  epidemic  of  great 
virulence.  Diphtheria  has  fortunately  been  robbed  of  its  worst 


460  PEDIATRICS  OF  THE  PAST 

terrors,  but  in  those  days  it  was  a  disease  to  be  feared  as  much 
as  any.  Brettonneau's  wonderful  treatise,  in  which  Bard's  essay 
was  printed  in  translation  as  a  basic  text,  was  not  yet  written, 
so  that  information  on  the  nature  and  management  of  the  disease 
was  of  especial  interest.  It  is  a  thin  little  volume,  to  be  found 
in  all  the  older  medical  libraries  and  a  treasure  to  be  coveted  by 
the  newer  ones.  The  extracts  chosen  are  well  worth  perusal  and 
need  no  comment.  The  descriptions  are  accurate  and  clear,  as 
good  as  any  text  of  today. 

Bard  deserves  to  be  remembered  as  a  medical  educator, 
a  skilful  physician  and  one  of  the  early  American  writers  on 
pediatrics. 

AN 
ENQUIRY 

INTO   THE 

NATURE,  CAUSE,  and  CURE, 

OF  THE 

ANGINA  SUFFOCATIVE  &C 

"As  a  faithful  and  accurate  history  of  diseases,  their  various  symp- 
toms and  method  of  cure,  is  the  most  effectual  way  of  promoting  the  art 
of  healing;  Physicians  should  describe,  with  the  utmost  care,  the  diseases 
they  would  treat  of;  and  the  good  and  bad  effects  of  any  method  or 
medicines  they  have  used  in  them.  But  in  a  more  particular  manner  is 
this  necessary,  when  any  new  and  uncommon  distemper  occurs,  of  which 
the  peculiar  pathognomonic  and  diagnostic  signs  should  be  carefully 
laid  down,  and  a  particular  account  given  of  what  evacuations,  regimen, 
and  medicines  were  useful  or  hurtful  in  it. 

Huxham  on  Fevers,  p.  267." 

From  a  conviction  of  the  truth  and  importance  of  these  observations, 
and  in  obedience  to  the  precept  of  so  great  a  Man  as  Huxham,  I  have 
determined  to  attempt  the  history  of  a  disease,  which  has  lately  appeared 
among  the  children  of  this  city;  and  which,  both  as  an  uncommon  and 
highly  dangerous  distemper,  well  deserves  an  attentive  consideration. 
In  delivering  it  therefore,  I  shall  first  carefully  enumerate  the  symptoms 
with  which  it  was  attended,  and  describe  the  appearance  which  occurred 
on  inspecting  the  bodies  of  such  as  died  of  it;  then  enquire  into  its  nature 
and  cause;  and  lastly  lay  down  the  method  of  cure  which  has  been  found 
to  be  most  successful  in  its  treatment. 

In  general,  this  disease  was  confined  to  children  under  ten  years  old, 
though  some  few  grown  persons,  particularly  women,  (while  it  prevailed) 


SAMUEL  BARD  461 

had  symptoms  in  some  respects  resembling  it.  Most  of  those  who  had  it 
were  observed  to  droop  for  several  days  before  they  were  confined.  And 
the  first  symptoms,  in  most  instances,  were  a  slightly  inflamed  and  watery 
eye,  a  bloated  and  livid  countenance,  with  a  few  red  eruptions  here  and 
there  upon  the  face,  and  in  one  case  a  small  ulcer  in  the  nose,  whence 
oosed  an  ichor  so  sharp  as  to  inflame  and  erode  the  upper  lip.  At  the 
same  time,  or  very  soon  after,  such  as  could  speak,  complained  of  an 
uneasy  sensation  in  the  throat,  but  without  any  great  soreness  or  pain. 
Upon  examining  it,  the  tonsils  or  almonds,  appeared  swelled  and  slightly 
inflamed,  with  a  few  white  specks  upon  them,  which,  in  some,  increased 
so  as  to  cover  them  all  over  with  one  general  slough,  and  in  a  few  the 
swelling  was  so  great,  as  almost  to  close  up  the  passage  of  the  throat;  but 
this,  altho*  a  frequent  symptom,  did  not  invariably  attend  the  disease; 
and  some  had  all  the  other  symptoms  without  it.  The  breath  was  either 
no  ways  offensive,  or  had  only  that  kind  of  smell  which  is  occasioned 
by  worms;  and  the  swallowing  was  very  little,  if  at  all,  impeded. 

These  symptoms,  with  a  slight  fever  at  night,  occurred  in  some  for 
five  or  six  days,  without  affecting  their  friends;  in  others  a  difficulty  of 
breathing  came  on  within  twenty-four  hours,  especially  in  the  time  of 
sleep,  and  was  often  suddenly  encreased  to  so  great  a  degree  as  to 
threaten  immediate  suffocation.  In  general,  however,  it  came  on  later, 
increased  more  gradually,  and  was  not  constant;  but  the  patient  would 
now  and  then  enjoy  an  interval  of  an  hour  or  two,  in  which  he  breathed 
with  ease,  and  then  again  a  laborious  breathing  would  ensue,  during 
which  he  seemed  incapable  of  filling  his  lungs,  as  if  the  air  was  drawn 
through  a  too  narrow  passage. 

This  stage  of  the  disease  was  attended  with  a  very  great  and  sudden 
prostration  of  strength;  a  very  remarkable  dry  cough;  and  a  peculiar 
change  in  the  tone  of  the  voice;  not  easily  described,  but  so  singular, 
that  a  person  who  had  once  heard  it,  could  almost  certainly  know  the 
disease  again  by  hearing  the  patient  cough  or  speak.  In  some  the  voice 
was  almost  entirely  lost,  and  would  continue  very  weak  and  low  for 
several  weeks  after  recovery.  A  constant  fever  attended  this  disease, 
but  it  was  much  more  remarkable  in  the  night  than  in  the  day  time; 
and  in  some  there  was  a  remarkable  remission  towards  morning.  The 
pulse  at  the  wrist  was  in  general  quick,  soft  and  fluttering,  though  not 
very  low,  and  it  was  remarkable,  that  at  the  same  time  the  pulsations 
of  the  heart  was  rather  strong  and  smart  then  feeble.  The  heat  was  not 
very  great,  and  the  skin  was  commonly  moist. 

These  symptoms  continued  for  one,  two,  or  three  days.  By  that 
time  it  was  usual  for  the  pulse  to  be  greatly  increased  in  such  as  died; 
and  these  patients,  though  commonly  somewhat  from  the  beginning, 
now  became  much  more  so;  yet  even  when  the  disorder  was  at  the  worst, 


462  PEDIATRICS  OF  THE  PAST 

they  retained  their  senses,  and  would  give  distinct  answers,  when  spoken 
to;  although  on  being  left  to  themselves,  they  lay  for  the  most  part  in  a 
lethargic  situation,  only  raising  up  now  and  then  to  receive  their  drink. 
Great  restlessness  and  jactation  came  on  towards  the  end  of  the  disease, 
the  sick  perpetually  tossing  from  one  side  of  the  bed  to  the  other,  but 
they  were  still  so  comatous  as  to  appear  to  be  asleep,  immediately  upon 
changing  their  situation  or  posture.  An  universal  languor  and  dejection 
were  observed  in  their  countenances;  the  swelling  of  the  face  subsided; 
a  profuse  sweat  broke  out  about  the  head,  neck  and  breast,  particularly 
when  asleep;  a  purging  in  several  came  on;  the  difficulty  of  breathing 
increased,  so  as  to  be  frequently  almost  entirely  obstructed,  and  the 
patient  died  apparently  from  suffocation.  This  commonly  happened 
before  the  end  of  the  fourth  or  fifth  day;  in  several  within  thirty-six 
hours  from  the  time  the  difficulty  of  breathing  first  came  on.  One  child, 
however,  lived  under  the  circumstances  to  the  eighth  day;  and  the  day 
before  he  died,  his  breath  and  what  he  coughed  up,  was  somewhat 
offensive;  but  this  was  the  only  instance  in  which  I  could  discover  any- 
thing like  a  disagreeable  smell,  either  from  the  breath  or  expectoration. 

Out  of  sixteen  cases  attended  with  this  remarkable  suffocation  in 
breathing,  seven  died;  five  of  them  before  the  fifth  day,  the  other  two 
about  the  eighth.  Of  those  who  recovered,  the  disease  was  carried  off, 
in  one,  by  a  plentiful  salivation,  which  began  on  the  sixth  day;  in  most 
of  the  others,  by  an  expectoration  of  a  viscid  mucus. 

I  distinguish  between  the  salivation  and  expectoration,  because  in 
one  the  discharge  seemed  to  come  from  the  salivary  glands,  and  was 
attended  with  little  or  no  cough;  in  the  others  it  manifestly  came  from 
the  Trachea,  and  was  attended  with  an  incessant  cough;  and  I  judged 
the  salivation  to  have  been  a  natural  crisis,  as  the  patient  had  taken 
but  six  grains  of  calomel  before  it  came  on.  Her  gums  were  not  inflamed, 
her  teeth  were  not  loose,  nor  had  her  breath  or  saliva,  the  smell  of  persons 
under  a  mercurial  salivation.  In  this  case  the  voice,  in  the  space  of  a 
few  hours,  from  being  pretty  strong  and  loud,  became  so  low  as  to  be 
with  difficulty  heard. 

One  of  the  first  families  in  which  this  disease  appeared  was  that  of 
Mr.  W.  W.  of  this  place.  He  had  seven  children  in  his  family,  all  of  whom 
were  taken  ill  one  after  another.  The  four  first  had  the  disease  as  I  have 
just  now  described,  and  three  of  these  died;  the  one  who  recovered  was 
the  instance  I  mentioned,  in  which  the  disease  was  carried  off  by  saliva- 
tion. The  other  three  were  the  youngest.  They  had  not  the  difficulty  of 
breathing,  but  in  its  stead,  very  troublesome  ulcers  behind  their  ears. 
These  began  with  a  few  red  pimples,  which  soon  ran  together,  itched 
violently,  and  discharged  a  great  deal  of  a  very  sharp  ichor,  so  as  to  erode 
the  neighbouring  parts,  and  in  a  few  days  spread  all  over  the  back  part 


SAMUEL  BARD  463 

of  the  ear,  and  down  upon  the  neck.  They  all  had  a  fever,  particularly 
at  night,  and  one  of  them  had  a  perpetual  tenesmus,  (or  urging  to  go  to 
stool.)  This  symptom  appeared  in  some  who  had  the  difficulty  of  breath- 
ing, but  in  none  to  so  remarkable  a  degree  as  in  this  child. 

After  this,  many  other  children  had  similar  ulcers  behind  their  ears, 
and  some  of  them  seemed  slightly  affected  with  the  difficulty  of  breath- 
ing, but  it  never  became  alarming  while  this  discharge  continued.  These 
ulcers  would  continue  for  several  weeks,  appeared  covered  in  some 
places  with  sloughs,  resembling  those  on  the  tonsils;  and  at  last  grew 
very  painful  and  uneasy. 

In  some  cases  they  were  attended  with  swelling  of  the  glands  under 
the  tongue  and  behind  the  ears,  which  subsided  on  the  eruptions  appear- 
ing, and  discharging  freely,  and  again  swelled  upon  the  discharge  being 
checked. 

I  met  with  nothing  like  this  complaint  in  adult  persons,  unless  the 
two  following  cases  may  be  considered  as  allied  to  it;  they  happened 
about  the  same  time,  and  both  were  women;  one  of  them  had  assisted 
in  laying  out  two  of  the  children  that  died  of  it.  At  first  her  symptoms 
resembled  rather  an  inflammatory  angina,  but  about  the  third  day  the 
tonsils  appeared  covered  with  thick  sloughs,  her  pulse  was  low  and  feeble; 
she  had  a  moist  skin,  a  dejection  of  spirits,  and  some  degree  of  anxiety; 
though  nothing  like  the  difficult  breathing  of  the  children. 

The  other  was  a  soldier's  wife,  who  for  some  time  before  she  perceived 
any  complaint  in  her  throat,  laboured  under  a  low  fever.  Her  tonsils 
were  swelled,  and  entirely  covered  with  sloughs,  resembling  those 
of  the  children;  but  her  breath  was  more  offensive,  and  she  had  no 
suffocation. 

I  have  had  an  opportunity  of  examining  the  nature  and  seat  of  this 
disease,  from  dissection,  in  three  instances.  One  was  a  child  of  three 
years  old.  Her  first  complaint  was  an  uneasiness  in  her  throat.  Upon 
examining  it,  the  tonsils  appeared  swelled  and  inflamed,  with  large 
white  sloughs  upon  them,  the  edges  of  which  were  remarkably  more 
red  than  the  other  parts  of  the  throat.  She  had  no  great  soreness  in  her 
throat,  and  could  swallow  with  little  or  no  difficulty.  She  complained  of  a 
pain  under  her  left  breast;  her  pulse  was  quick,  soft  and  fluttering.  The 
heat  of  her  body  was  not  very  great,  and  her  skin  was  moist;  her  face 
was  swelled,  she  had  a  considerable  prostration  of  strength,  with  a 
very  great  difficulty  of  breathing,  a  very  remarkable  hollow  cough, 
and  a  peculiar  change  in  the  tone  of  her  voice.  The  next  day,  her  difficulty 
of  breathing  was  increased,  and  she  drew  her  breath  in  the  manner 
before  described,  as  if  the  air  was  forced  through  too  narrow  a  passage, 
so  that  she  seemed  incapable  of  filling  her  lungs:  She  was  exceedingly 
restless,  tossing  perpetually  from  side  to  side,  was  sensible,  and  when 
asked  a  question,  would  give  a  pertinent  answer,  but  otherways  she 


464  PEDIATRICS  OF  THE  PAST 

appeared  dull  and  comatous.  AH  these  symptoms  continued,  or  rather 
increased,  until  the  third  night,  on  which  she  had  five  or  six  loose  stools, 
and  died  early  in  the  morning. 

Upon  examining  the  body,  which  was  done  on  the  afternoon  of 
the  day  she  died,  all  the  back  parts  of  the  throat,  and  the  roof  of  the 
tongue  were  found  interspersed  with  sloughs,  which  still  retained 
their  whitish  colour.  Upon  removing  them,  the  parts  underneath  appeared 
rather  pale  than  inflamed.  No  putrid  smell  could  be  perceived  from 
them,  nor  was  the  corps  in  the  least  offensive.  The  Oesophagus,  or 
gullet,  appeared  as  in  a  sound  state.  The  epiglottis,  which  covers  the 
wind-pipe,  was  a  little  inflamed,  on  its  external  surface,  and  on  the 
inner  side,  together  with  the  whole  larynx,  was  covered  with  the  same 
tough  white  sloughs,  as  the  glands  of  the  throat.  The  whole  trachea 
quite  down  to  its  division  in  the  lungs,  was  lined  with  an  inspissated 
mucus,  in  form  of  a  membrane,  remarkably  tough  and  firm;  which, 
when  it  came  into  the  lungs,  seemed  to  grow  thin  and  disappear:  It 
was  so  tough  as  to  require  no  inconsiderable  force  to  tear  it,  and  came 
out  whole  from  the  trachea,  which  it  left  with  much  ease;  and  resembled 
more  than  any  thing,  both  in  thickness  and  appearance,  a  sheath  of  thin 
shammoy  leather.  The  inner  membrane  of  the  trachea  was  slightly 
inflamed;  the  lungs  too  appeared  inflamed,  as  in  peripneumonic  cases; 
particularly  the  right  lobe,  on  which  there  were  many  large  livid  spots, 
though  neither  rotten  or  offensive;  and  the  left  lobe  had  small  black 
spots  on  it,  resembling  those  marks  left  under  the  skin  by  gun  powder. 
Upon  cutting  into  any  of  the  larger  spots,  which  appeared  on  the  right 
lobe,  a  bloody  sanies  issued  from  them  without  frothing,  whereas  upon 
cutting  those  parts  which  appeared  sound,  a  whitish  froth,  but  slightly 
tinged  with  blood,  followed  the  knife. 

The  second  dissection  I  attended,  was  of  a  child  about  seven  years 
old,  who  had  had  all  the  symptoms  with  which  this  disease  is  commonly 
attended,  except  that  in  this  case  the  glands  of  the  throat,  and  upper 
parts  of  the  wind  pipe,  were  found  entirely  free  from  any  complaint, 
and  the  disease  seemed  to  be  confined  to  the  trachea  only,  which  was 
lined  with  this  tough  mucus,  inspissated  so  as  to  resemble  a  membrane: 
We  could  trace  it  into  the  larger  divisions  of  the  trachea,  and  it  was 
evident  that  the  smallest  branches  were  obstructed  by  it,  for  it  was  very 
observable,  that  upon  opening  the  breast  the  lungs  did  not  collapse  as 
much  as  is  usual,  but  remained  distended,  and  felt  remarkably  firm  and 
heavy,  as  if  they  were  stuffed  with  the  same  mucus. 

The  last  was  a  child  of  about  three  years  old,  who  died  in  thirty-six 
hours  after  the  difficult  breathing  first  came  on;  yet  even  in  this  case,  I 
discovered  and  shewed  to  several  by-standers,  the  inspissated  mucus 
which  lined  the  trachea,  and  which  was  so  remarkable  as  to  be  evident 
to  all  who  saw  it,  that  it  must  have  been  the  cause  of  the  child's  death. 


THE  PEDIATRIC  POEMS 

PEDIATRIC  poems  are  rather  numerous  and  this  method  of 
instruction  has  persisted  even  in  our  time.  The  health  clown 
instructing  and  amusing  the  children  is  the  direct  descendant 
of  his  counterpart  in  the  Middle  Ages,  when  the  unlettered  were 
entertained  and  taught  not  only  about  their  gods  and  heroes  but 
about  the  care  of  themselves  and  their  children.  A  perusal,  par- 
ticularly of  the  German  texts,  makes  it  clear  that  infant  welfare 
was  remarkably  well  taught. 

VERSEHUNG   DES    LEIBS    [1491] 

Curiously  enough  the  earliest  German  pediatric  poem  with 
which  we  are  familiar  was  the  work  not  of  a  physician  but  of  a 
monk,  Heinrich  von  Louffenburg.  Careless  of  the  spelling  then 
as  now  the  name  also  appears  as  Laufenberg  and  Loufenburg. 
Apparently  he  was  a  native  of  Loufenburg  on  the  Rhein  and  he 
first  appears  in  1434  as  dean  of  the  Mauritiusstift  in  Zofingen. 
Later  he  was  in  Freiburg  but  in  1445  ne  withdrew  from  the  world, 
became  a  monk  and  entered  the  Johanniterkloster  "zum  griinen 
Werde"  in  Strassburg.  He  was  alive  there  in  1458  but  died  about 
this  time  or  soon  after.  His  literary  work  was  accomplished  chiefly 
between  14 15  and  1458.  He  left  a  large  collection  of  manuscripts 
including  many  songs,  some  popular,  as  "Ich  wolt,  dass  ich 
doheime  war,"  many  church  compositions,  translations  of  Latin 
church  poetry  into  popular  dialect,  and  many  poems  written  for 
and  about  the  Virgin  Mary.  He  wrote  two  long  symbolic  poems, 
"Der  Spiegel  menschlichen  Heils,"  a  translation  or  adaptation  of 
"Speculum  humanae  salvationis"  containing  some  15,000  lines, 
and  "Das  Buch  der  Figuren,"  with  over  25,000  lines.  Schumann 
gives  a  brief  account  of  him  and  the  sources  of  information.1 

The  chief  interest  attaches  to  "Versehung  des  Leibs,"  which 
was  written  in  1429.  Schumann  refers  to  it  as  a  translation  of  the 
"Regimen  Sanitatis"  which  may  have  indeed  served  as  a  source 
or  as  an  inspiration.  The  poem  is  written  in  what  we  know  today 
as  old  Swabian  and  there  were  two  if  not  more  reprints  of  the 
pediatric  parts  as  noted  below.  Some  extracts  were  reprinted  by 

1  Allgemeine  deutsche  Biographie,  xix,  811. 

465 


466  PEDIATRICS  OF  THE  PAST 

Baas.2  It  is  also  noted  by  Sudhoff.3 

Baas  compared  the  manuscript  in  the  Munich  library  with 
the  original.  This  manuscript  has  157  leaves  and  contains  over 
1,500  verses.  It  is  practically  the  same  as  the  printed  edition. 
It  is  not  strictly  limited  to  pediatrics  but  contains  an  important 
section  on  this  subject.  It  was  printed  at  Augsburg  in  1491  and 
is  listed  by  Hain  as  number  160 17.  Panzer  in  his  "Annalen  der 
alteren  deutschen  Literatur"4  describes  it  as  number  322.  On 
the  back  of  the  title  page  is  a  woodcut  figuring  God  the  Father; 
a  rhymed  table  of  contents  follows.  The  book  is  divided  into 

fei0  bucblein  ift  alfo  gcmacbt 

me  t>5  jar  iiad)  be  monat  wirt  $c/ 
1RacbnaturvfiinflaP6ltcm  (acljt 

aucb  tbat  cs  weiter  lem 
^011  fpciP  traiicfc  ^n  purgteren 

baoen  laficii  vnb  regierat 
0cb  wager  frawc  biefrucbtberfinb 

wie  man  5iebcn  foil  bic  fciub 
^0:  6  pc(tilcnc5  ftcb  macbeii  frcf 

barub  id  cs  cm  biicb  6  arc5HCf 

First  page  of  "Versehung  des  Leibs." 

seven  chapters.  The  first  chapter  contains  a  calendar  and  before 
each  month  there  is  a  woodcut  showing  the  things  most  likely 
to  happen  in  that  month,  and  then  follow  in  rhyme  the  pre- 
cautions one  should  take  to  protect  his  health  during  this  month. 
The  second  chapter  deals  with  the  seven  planets.  The  third 

2  Bass,   Ztschr.  f.    d.   Gescbicbte   des   Oberrbeins,  xxxi,    iii,    363-389.  Ztscbr.  J. 
Bejorderung  der  Gescbicbtskundev  on  Freiburg,  "Alemannia,"  1905,  xxxm,  xli,  235. 

3  Sudhoff,  K.  Studien  zu  Geschichte  der  Medizin,  1908,  11,  17-20. 

4  Nurnberg,   1788,  vol.  1. 


THE  PEDIATRIC  POEMS  467 

chapter  tells  of  the  nature  of  the  twelve  signs.  The  fourth  chapter 
explains  how  the  year  is  divided  into  four  parts,  also  the  four 
elements  and  the  four  complexions.  The  fifth  chapter  concerns 
the  ordering  of  health,  and  the  sixth  pregnant  women.  The 
seventh  chapter  is  about  Die  Pestilenz  or  the  plague.  There  aer 
numerous  woodcuts  illustrating  the  text.  The  pages  are  not 
numbered.  The  author  states  on  the  last  page  that  he  wrote  this 
poem  in  1429. 

Part  of  the  poem  resembles  the  "Regimen  Sanitatis"  and 
some  the  "Speculum  naturale"  of  Vincenz  of  Beauvais.  Louffen- 
burg  evidently  was  familiar  with  medical  writers  and  medical 
practice. 

The  illustrations  which  are  reproduced  are  of  great  interest  as 
examples  of  the  earliest  pediatric  cuts  made  for  popular  instruc- 
tion. The  forerunner  of  the  "kiddie  car"  is  remarkable. 

The  introduction  and  a  short  excerpt  will  show  the  spirit  of 
the  original. 

Versehung  des  Leibs 

Dis  buchlein  ist  also  gemacht 

wie  dz  jar  nach  de  monat  wirt  geacht 
Nach  natur  vii  influss  d*  stern 

auch  thut  es  weiter  Iern 
Uon  speiss  tranck  vii  purgieren 

baden  Iassen  vnd  regieren 
Schwager  frawe  die  fruchtber  sind 

wie  man  ziehen  soil  die  kind 
Uor  d'  pestilencz  sich  machen  frey 

dariib  ist  es  ein  buch  d'  arczney 

1 49 1,  Augspurg. 
Darnach  magstu  hie  Iesen 

was  den  sein  speise  sol  wese 
Davo  sag  ich  dir  als  ich  Iisen 

das  man  es  nyena  mit  soil  spisen 
Den  allein  mit  milch  so  Iang 

bis  an  der  zenlin  auffgang 
Was  man  jm  ander  speise  geit 

den  von  milch  zu  diser  zeyt 
Die  ist  ein  sache  zu  seinem  todt 

oder  fuget  im  de  siechen  not 
Aber  doch  so  soltu  mercken 

dz  kein  milch  dz  kind  mag  stercke 
So  wol  als  von  der  mutter  sin 


468  PEDIATRICS  OF  THE  PAST 

als  ich  des  underweiset  bin 
Darumb  so  soil  es  mit  geluste 

saugen  sein  mutter  bruste 
Von  d'  so  Iebet  es  bas  on  we 

den  von  andern  frawen  me 
Wen  es  hat  ir  gewonet  zwor 

jn  mutter  Ieib  da  es  was  vor 
Doch  so  soil  die  mutter  wissen 

das  sy  soil  sein  geflissen 
Das  sy  trincke  esse  als  sy  vor  thet 

da  sy  das  kind  in  dem  Ieib  hett 
Auch  das  dz  kinde  vertewe  wol 

die  milch  so  soil  sy  es  drey  mol 
Oder  zwiirend  czu  dem  tage 

seugen  als  ich  Ieren  mage 
So  Iang  bis  es  erstercke  sich 

denn  so  sol  sy  taglich 
Das  kindlin  dicke  saugen  Ion 

ye  ein  wenig  solt  verston 
Das  es  die  milche  dester  bass 

vertewe  darumb  Iere  ich  das 
Darczii  so  were  jm  gfitte 

nach  weiser  Ierer  mutte 
Das  man  wenig  honig  im  gebe  ein 

vor  der  milch  der  mutter  sein 
Auch  so  soil  denn  alle  morgen 

die  mutter  des  nit  borgen 
Sy  soil  die  groben  milch  vor  an 

ausser  jren  brusten  Ian 
E  sy  das  kindlein  saugen  Iosz 

darczu  so  spricht  ein  meister  grosz 
Das  es  auch  sey  gesunde 

dem  kind  zu  der  selben  stunde 
So  es  sauge  das  es  auch  wein 

senfftigklich  damit  ein  klein 
Auch  sage  ich  hie  mit  vnderscheit 

wie  wol  ich  han  ze  neste  geseit 
Das  kein  milch  tauge  dem  kindlein 

bas  dann  von  der  mutter  sein 
So  soil  die  mutter  doch  an  stett 

wen  sy  erst  geborn  hett 
Wie  man  die  Kindlein  spersen  soil 

od  seugen  in  ir  jugent. 
Ich  sperz  in  seiig 


THE  PEDIATRIC  POEMS  469 

Das  kindlin  seugen  nit  ze  stund 

wen  ir  milch  were  yngesund 
Von  sachen  die  ich  nit  sagen  wil 

sy  soil  beitten  an  das  zil 
Das  die  briiste  siczent  nider 

nach  geschwulst  so  Iange  sider 
Sol  es  ein  ander  frawe  seugen 

vnd  den  die  mutter  sunder  Ielige 
Auch  soil  allczeit  geflissen  sein 

ein  frawe  ob  das  kindelein 
Sich  hette  zu  vast  ubersogen 

dz  jm  darnach  werden  vnderzoge 
Die  milch  vnd  auch  die  briiste 

jch  wolt  das  mengklich  wuste 
Das  dem  kindlein  komet  we 

wen  es  sauget  zeuil  vnd  me 
Wen  so  mag  es  vertewen  nicht 

die  milch  dauon  im  we  geschicht 
Von  blaste  in  seinem  Ieibe 

davon  sollent  die  weibe 
Den  kindlein  nitgen  zeuil 

zu  einem  mal  als  ich  hie  wil 
Fugt  sich  obe  das  kinde 

anders  geren  begiinde 
Zu  essen  den  ich  han  geseit 

des  gib  ich  im  mit  bescheideheit 
Ob  es  im  sey  gesunde 

ob  man  auch  villeicht  funde 
Ein  kinde  das  m&cht  trinken  wein 

des  m6cht  man  im  auch  gebe  ein 
Doch  selten  vnd  gar  kleine 

gemiischet  mit  wasser  reine 
Besunder  ob  man  wol  enpfunde 

das  er  im  wol  thet  etlich  stunde 
Wie  man  die  soil  halten  so 

im  die  zene  auff  gand 
Ich  Ierte  geren  mein  kindlein  gon 

darumb  so  fiire  ich  es  gar  schon. 

PROPER  CARE  OF  THE  BODY5 

This  little  book  conveys  information 
on  the  different  months  of  the  year, 
as  to  natural  conditions  and  the  influence  of  the  stars. 
*  Translation  by  Professor  Hermann  CoIIhz  of  Baltimore. 


47o  PEDIATRICS  OF  THE  PAST 

It  further  gives  instruction 

on  food,  drinking  and  purging, 

on  bathing  and  the  guidance 

of  pregnant  women, 

on  the  bringing  up  of  children, 

and  on  the  way  to  avoid  pestilence. 

Accordingly  it  is  a  book  of  medicine. 

1 49 1,  Augsburg. 

Now  you  may  read  here 

what  kind  of  food  it  should  be  given. 

Concerning  this  I  tell  you,  as  I  have  ascertained, 

that  it  should  have  no  other  food 

than  milk  alone,  until  it  cuts  its  teeth. 

If,  at  this  time,  it  be  given 

other  food  than  milk, 

death  may  follow 

or  serious  illness  befall  the  child. 

But  you  must  also  be  aware  of  the  fact 

that  no  milk  will  make  the  child  so  strong 

as  that  from  its  mother, 

if  you  will  accept  my  advice. 

Therefore  the  child  should  delight 

in  taking  its  mothers  breast. 

On  that  it  subsists  better  and  without  harm 

than  on  that  of  any  other  woman, 

because  it  became  accustomed  to  it 

in  the  mother's  womb 

where  it  was  formerly. 

Yet  this  the  mother  must  know 

that  she  must  be  careful. 

to  drink  and  eat  the  same  food  as  she  did  heretofore 

when  she  was  pregnant. 

Also  should  she,  so  that  the  child  may  well  digest  it, 

give  it  milk  three  times 

or  twice  a  day, 

suckling  it — as  I  can  instruct — 

until  it  becomes  stronger. 

Thereupon  she  should  daily 

allow  the  child  to  suck  frequently: 

each  time  just  a  little,  you  must  understand, 

so  that  the  child  may  all  the  better 

digest  the  milk:  that  is  my  advice. 

In  addition,  it  would  be  advisable, 

in  the  opinion  of  wise  teachers, 


Eicmcl)  man  gefcriben  vinb 
wte  man  regiere  fol  bic  kinb 
tSbit  be  bae  in  gebd:ent  58 
bribe  fpat  ^nb  aucl)  fra 
Wen  tr  nature  bic  id  5artc 

bauon  wil  tdj  bas  man  ir  warte 
iMbit  funberlictyer  batre 
bic  in  ill  nucs  vhb  gfittc 


Page  from  "Versehung  des  Leibs. 


472  PEDIATRICS  OF  THE  PAST 

to  give  the  child  a  little  honey 

before  its  mother's  milk. 

Moreover  the  mother  must  not  omit 

to  see  to  it  every  morning 

that  she  let  the  coarse  milk 

flow  from  her  breast 

before  she  lets  her  child  suck. 

Furthermore  we  are  told  by  a  great  master 

that  it  would  be  wholesome 

for  the  child,  at  the  same  time 

that  it  sucks,  also  to  cry  a  very  little. 

Specifically  I  wish  to  add, 

having  said  heretofore, 

that  no  milk  is  good  for  the  child 

except  the  one  of  its  mother, 

(that)  nevertheless  the  mother 

after  having  given  birth  to  the  child, 

shall  not  suckle  it  at  once 

in  case  her  milk  is  unwholesome 

owing  to  reasons  I  will  not  mention. 

She  should  wait  long  enough 

for  her  breasts  to  settle 

after  the  swelling.  In  the  meantime 

another  woman  shall  suckle  the  child, 

instead  of  the  mother,  no  doubt. 

In  addition  a  woman  always  should  make  sure 

that  the  child  has  not  sucked  too  much, 

in  order  that  thereupon  be  withdrawn  from  the  child 

both  the  milk  and  the  breasts. 

I  wish  everybody  knew 

that  the  child  will  suffer  harm 

when  it  sucks  too  much  and  more  [than  enough]. 

For  then  it  cannot  digest 

the  milk,  whereby  it  will  suffer  harm 

by  flatulence  in  its  body. 

Hence  women  should 

not  [give]  children  too  much 

at  one  time,  as  I  here  state. 

Should  it  happen  that  the  child 

started  to  express  a  desire 

to  eat  other  things  than  those  I  have  mentioned, 

they  may  be  given  to  it  with  discretion, 

making  sure  that  they  will  be  wholesome. 

Even  if  a  child  should  be  found 


THE  PEDIATRIC  POEMS  473 

desirous  of  drinking  wine, 

one  migfit  give  it  some, 

but  rarely  and  only  a  small  quantity 

mixed  with  pure  water, 

especially  if  one  should  find 

that  it  benefited  the  child  on  more  than  one  occasion. 


EIN   REGIMENT   DER   GESUNDHEIT   FUR   DIE   JUNGEN    KINDER 

The  pediatric  part  just  referred  to  was  reprinted  in  1532,  in 
Meintz,  by  Peter  Jordan  and  to  this  was  added  a  Vorrede,  a 
table  of  contents  and  after  the  poem  some  pages  in  prose  con- 
cerning the  common  ailments  of  children  and  their  treatment, 
evidently  drawing  on  Metlinger  for  the  material.  There  is  also  a 
table  showing  the  German  equivalents  of  the  Latin  names  of 
plants.  In  this  edition  the  text  was  translated  or  rather  rewritten 
in  the  current  German,  so  that  while  the  origin  is  clear  the  word- 
ing and  rhyming  have  been  much  changed.  Jordan  in  the  Vorrede 
states  that  it  had  been  previously  printed  in  "eym  biichlin  der 
frawen  rosen  gart  genant."  This  is  also  true  of  the  edition  of 
1544  printed  by  Hermann  Gulfferich  "in  der  Schnurgassen  zum 
Krug  in  Frankfurt  an  Mayn."  Gulfferich  printed  numerous 
popular  medical  works  in  the  forties  and  fifties  of  the  sixteenth 
century.  The  original  illustrations  were  reproduced  with  some 
variations  and  there  were,  of  course,  the  usual  typographical 
errors. 

Prof.  Hermann  CoIIitz  of  Baltimore  kindly  made  a  transla- 
tion using  the  text  of  1549,  which  gives  a  good  idea  of  popular 
pediatric  instruction  in  Germany  in  the  middle  of  the  sixteenth 
century  and  it  compares  favorably  with  that  of  the  present  day. 
Child  hygiene  has  probably  not  traveled  as  far  as  some  of  the 
present  day  exponents  would  have  us  believe. 

EIN    REGIMENT    DER    GESUNDHEIT    FUR    DIE    JUNGEN    KINDER,    (ETC.), 

FOL.    Ill    SEQ. 

instruction  for  pregnant  women  bow  they  should  behave 

(Woodcut)6 

Pregnant  women  should  bear  in  mind  /  that  at  all  times  they  must  guard 
against   anger   and   great  fright;  and — last  not  least — /  must  avoid 
becoming  low-spirited. 
c  The  same  woodcut  is  found  on  f.  vma,  where  it  properly  belongs. 


474  PEDIATRICS  OF  THE  PAST 

None  shall  be  bled  /  except  in  case  of  absolute  need, 

unless  it  be  about  the  time  and  hour  /  that  she  approaches  her  last 

month. 
Hereby  one  must  also  see  to  it  /  that  she  be  healthy  and  strong. 
With  prudence  she  must  guard  /  against  falling,  hitting  and  any  harm. 
She  must  also  remain  free  of  worry  /  that  she  may  not  become  mentally 

deranged. 
However  that  which  cheers  them  up,  /  let  it  be  by  means  of  joking  or 

laughing, 
as  a  pastime  in  a  becoming  manner.  /  Yet  they  should  take  this  advice, 
that  they  must  keep  quiet,  /  and  keep  up  their  work  in  a  moderate 

fashion. 
They  should  also  faithfully  refrain  /  from  running  fast  and  from  riding 

on  horseback. 
They  must  avoid  frost  and  cold  /  and  keep  away  from  strong  winds. 
Nor  indeed  is  the  heat  /  good  for  them  during  these  times  either. 
Rest  and  sleep  would  benefit  them  above  all.  /  As  concerns  everything 

they  crave  for, 
provided  it  be  obtainable,  /  it  may  be  of  no  little  benefit  to  the  fetus, 
whether  it  be  drink  or  food.  /  But  there  is  one  thing  they  must  not  forget, 
namely,  to  beware  of  bathing  too  much  /  so  as  not  to  suffer  any  harm 

thereby. 
When  they  reach  their  last  month  /  bathing  may  be  of  advantage  to 

them, 
but  let  it  be  understood  that  the  water  must  be  warm  /  and  prepared 

with  herbs, 
with  marsh  mallows,  mallows,  violets,  acanthus.  /  Let  the  woman  sit 

down  in  the  bath. 
But  she  must  not  sit  in  it  too  long  /  and  should,  moreover,  gently  per- 
spire, 
so  that  she  may  not  swoon.  /  On  leaving  the  bath 
her  whole  body  should  be  /  rubbed  with  an  ointment, 
made  of  violets  /  or  fine  mallows. 
They  must  make  a  point  of  being  moderate  /  as  regards  eating  and 

drinking. 
Yet  they  must  not  suffer  from  hunger  /  and  must  likewise  avoid  excessive 

thirst. 
They  should  eat  small  portions  and  at  frequent  intervals  /  using  their 

own  judgment  as  to  their  actual  needs. 
Let  them  endeavor  to  act  sensibly.  /  They  must  avoid  hard  coarse  food. 
Dried  beef  or  pork,  /  beans,  lentils  they  should  be  granted. 
On  the  other  hand,  barley  and  raw  fruit  /  should  be  avoided  at  all  times. 
They  must  refrain  from  all  kinds  of  fish,  /  however,  eggs  softly  boiled 
are  good  for  them  at  any  time;  /  also  veal  is  permitted  to  them. 


THE  PEDIATRIC  POEMS  475 

Of  chickens,  young  Iambs,  /  stags,  deer,  wild  fowl 

and  other  game  properly  prepared  /  they  should  make  use  at  this  time. 

Liquid  medicine  they  should  avoid.  /  They  must  always  see  to  it  that 

their  bowels  move  regularly. 
In  case  they  should  suffer  from  constipation,  /  the  best  remedy  for  them 

is 
a  vegetable  dish  of  spinach  thoroughly  cooked  /  and  prepared  with 

butter. 
They  must  also  carefully  guard  /  at  this  time  against  unpleasant  odors 
so  that  they  may  not  be  seized  with  faintness.  /  And  should  they  by 

chance 
fall  in  a  swoon,  /  then  remember  this  advice  of  mine : 
Take  distilled  water,  /  a  herb  called  ox-tongue  (bugloss), 
mix  it  with  rose  water,  /  and  add  a  little  saffron. 
After  being  mixed  together  very  evenly,  /  a  little  kerchief  should  be 

soaked  in  it. 
This  latter  should  be  placed  on  the  heart  of  the  woman;  /  it  takes  away 

faintness  and  pain. 
They  shall  also  every  week  /  wash  their  feet  in  water. 
Rock-moss  and  pure  camomiles  /  must  be  boiled  in  the  water, 
and  also  a  little  salt  should  be  added.  /  Therein  shall  she  wash  her  feet. 
And  during  the  time  /  of  her  period  be  careful 
to  give  the  woman  milk  or  porridge  to  eat;  /  but  it  is  best  to  dip  into  this 

milk 
a  redhot  iron  beforehand.  /  This  will  have  the  effect  of  stopping  the  flow. 
Yet  at  the  same  time  she  should  seek  /  medical  advice  if  she  has  an 

opportunity. 
During  this  time  she  must  avoid  /  indulging  in  unnecessary  exertion 
commonly  connected  with  love.  /  One  more  advice  I  wish  to  add: 
When  they  come  to  their  last  month  /  they  must  carefully  avoid 
exerting  themselves  too  much  /  by  walking  or  lifting  to  excess. 
Then  when  the  time  approaches  /  for  delivering 
they  should  take  gentle  walks  /  or  go  up-  and  downstairs 
so  as  to  feel  easy  and  ready  /  to  give  birth  to  a  child  without  any  pain. 
Afterwards  when  she  is  in  labor  /  I  advise  you  to  give  her  hellebore 
that  she  may  thereby  be  forced  instantly  to  sneeze  /  and  hence  find  it 

easier  to  be  delivered. 
Then  after  she  has  cheerfully  given  birth  /  one  shall  well  take  care  of  her. 
Her  food  must  be  delicate;  /  fowl  is  good  for  her. 
Her  chief  beverage  must  be  wine.  /  But  well  must  she  be  guarded 
against  fear  and  fright — mark  my  words — ,  /  nor  must  she  be  given  any 

honey. 
Herewith  endeth  this  chapter  concerning  the  line  of  conduct  for  preg- 
nant women. 


Darnad)  magllu  biclefcn 
was  ben  reinfpeifcfolwcfc 
*feauo  fag  id)  bir  als  icb  lifen 
bas  man  es  n^ena  mit  foil  fpifeii 
feen  allein  mit  mild)  fo  bug 
bis  an  bcr  5enlin  auffgang 
Was  man  f  m  ember  fpcife  gcit 
ben  -von  mild)  36  bifer  5Cf  t 


Page  from  "Versehung  des  Leibs.' 


THE  PEDIATRIC  POEMS  477 

how  the  newborn  child  should  be  cared  for. 
The  Mother: 

I  have  given  birth  to  a  tender  child  /  and  have  deserved  that  one  takes 
well  care  of  me. 

(woodcut) 

Now  let  us  hear  how  one  shall  /  manage  the  young  children 

regarding  all  that  concerns  them :  /  eating  and  drinking  at  a  late  and  at 

an  early  hour, 
sleeping  and  being  awake  and  similar  functions  /  and  particularly  nursing 

them. 
For  their  nature  is  weak  and  tender;  /  hence  they  are  in  need  of  nursing. 
The  first  thing  you  ought  to  do  /  after  the  birth  of  the  child 
is  to  pound  together  /  salt  and  roses  in  proper  quantity, 
and  sprinkle  and  clean  with  this  mixture  /  body,  face,  arms  and  legs  of 

the  child. 
Or  rub  it  with  a  salve  of  acorn-oil,  /  for  this  will  agree  well  with  the  child, 
and  will  strengthen  all  its  limbs;  /  it  should  also  harden  its  skin. 
Then  cut  off  its  navel  nicely  /  four  fingers'  width  from  its  stomach. 
After  that  you  should  further  care  for  the  child  /  by  strewing  on  the  cut 

of  the  navel 
a  powder,  of  healing  qualities,  /  made  up  of  bole  and  dragon's  blood, 
sarcocolla  and  pure  myrrh;  /  Roman  cumin  shall  also  be  contained  in  the 

powder. 
Cover  it  with  cotton  dipped  /  in  sweet-oil,  and  then  bandage  it  tightly 
and  carefully  with  soft  cloth.  /  When  you  bathe  it,  be  very  particular 
that  the  navel  not  be  hurt  /  so  that  it  may  eventually  fall  off  by  itself. 

how  a  bath  should  be  given  to  children. 

The  Mother: 

I  will  be  intent  on  bathing  my  child  /  often  and  frequently,  to  avoid 
various  ills. 

(woodcut) 

Now  mark  carefully  what  I  tell  you:  /  You  must  bathe  the  child  every 

day 
in  lukewarm  water,  and  immediately  /  after  the  bath  you  should  rub  it 
with  rose-oil;  that  will  well  agree  with  the  child.  /  at  the  same  time  you 

should 
stroke  its  limbs  up  and  down,  /  because  it  may  help  to  strengthen  them. 
You  may  also  gently  bend  them,  /  as  long  as  they  are  so  tender, 
according  to  your  own  judgment,  /  so  that  they  may  grow  well- formed. 


•nf~  tenad)  fo  merckiws  ic\)  biv  fag 

w%    b5  man  55  Wnt>  babe  alltag 
-■•  A3f  n  lawem  waiter  -\>n  barnad? 

fo  ce  auf  ban  babe  gat 
JG&it  rofdll  foltu  €0  50  (tunt 

falbett  ba*  ill  im  gefunt 
3lucb  fo  foltu  fein  geliber 

fcrac5e»  auff -vnb  nibcr 


Page  from  "Versehung  des  Leibs." 


THE  PEDIATRIC  POEMS  479 

You  may  likewise  gently  form  /  the  child's  ears  as  long  as  they  are  still 

tender, 
also  its  nose  and  its  little  head  / 
by  means  of  your  hands  in  the  best  possible  manner.  /  Finally  stroke  its 

little  belly, 
and  then  take  it  up  and  keep  on  bestowing  on  it  the  best  care  /  with 

regard  to  every  detail. 

HOW   THE    CHILD   MUST   BE    SWADDLED   and   put    tO    bed. 

The  Mother: 

I  keep  my  child  quiet  in  a  gentle  manner  /  and  wrap  it  up  in  cloths. 

Now  mark  further  what  I  say:  /  After  the  third  or  fourth  day  when  its 
navel  falls  off,  /  you  should  take  egg-shells, 
pound  them  to  powder  /  and  mix  it  well  with  wine. 

Sprinkle  with  this  mixture  its  delicate  navel,  /  and  then  bind  it  firmly 
in  very  clean  cloths.  /  Stretch  your  child's  arms  and  legs  well. 
Cover  its  head  very  thinly  /  or  wind  something  round  it  neatly. 
Also  must  the  head  lie  higher  than  its  body.  /  After  that  rock  the  child 
to  and  fro,  yet  gently  and  noiselessly.  /  Sing  also  at  the  same  time  a 

sweet  melody 
in  an  undertone  without  much  noise.  /  That  will  help  the  child  in  more 

than  one  way; 
it  will  exhilarate  its  mind  /  and  prepare  it  for  sweet  sleep. 
Then  when  it  is  quite  gently  asleep  /  you  must  further  look  out 
that  the  child  will  not  be  seized  with  fright.  /  Then  put  it  in  a  quiet 

place 
with  its  cradle,  making  no  noise,  /  in  a  cool  and  dark  place. 
Cover  the  child's  eyes  /  so  that  it  may  not  see  the  daylight. 
In  this  way  its  eyes  will  gain  strength.  /  When  afterwards  it  awakes  from 

its  sleep, 
it  is  best  to  turn  its  eyes  /  towards  daylight. 

After  that  a  bath  will  be  wholesome  for  the  child;  /  you  ought  to  bathe  it 
so  long  until  its  body  /  shows  a  red  glow;  then  it  is  time 
for  the  child  to  be  taken  out  of  the  bath.  /  But  mark  also  this  advice: 
the  water  shall  only  be  lukewarm.  /  Afterwards  rub  it  gently  with  honey. 
Then,  wash  without  soap  /  its  ears  and  eyes  clean; 
after  that  wipe  it  with  clean  cloths.  /  Finally  you  should  also  carefully 
anoint  the  child  with  sweet  oil  /  all  over  its  body. 
Then  you  should  also  bend  its  limbs  /  to  and  fro,  up  and  down: 
legs,  neck,  back,  hands,  /  arms,  sides  and  loins, 
as  you  wish  them  to  be  shaped:  /  such  a  proceeding  will  prove  beneficial 

in  many  respects. 


48o  PEDIATRICS  OF  THE  PAST 

HOW   A   MOTHER 

must  suckle  and  feed  a  child. 

The  Mother: 

I  feed  and  suckle  my  little  child 
according  to  its  nature  and  need. 
Nothing  is  more  wholesome  for  children 

in  their  early  years  than  milk-food. 
With  this  food  you  should  nourish  them 

until  they  cut  their  teeth. 
In  case  one  gives  them,  before  this  time, 

other  food  than  milk, 
they  will  become  ill. 

Another  fact  you  must  bear  in  mind, 
namely,  that  no  milk  imparts  more  strength  to  the  child 

than  the  milk  which  it  sucks  from  the  mother. 
Hence  it  should  be  delighted  merely 

to  draw  the  breast  of  its  mother. 
On  that  it  lives  much  better,  and  without  harm, 

than  on  the  milk  of  any  other  woman. 
However  this  the  mother  should  know 

that  she  must  be  just  as  careful 
concerning  eating  and  drinking,  as  formerly 

when  she  was  pregnant. 
In  order  that  the  child  may  digest  the  milk  well, 

she  should  suckle  it  three  times 
or  twice  a  day, 

until  it  has  gained  sufficient  strength. 
And  when  it  can  digest  better, 

she  should  let  it  suckle  frequently. 
But  not  much  at  a  time 

that  it  may  well  digest  the  quantity  imbibed. 
The  mother  must  likewise  be  careful 

to  remove  in  advance 
her  coarse  milk  every  morning; 

otherwise  some  harm  might  arise 
if  she  allowed  the  child  to  suck  it. 

Nor  should  she  hesitate, 
in  case  her  breasts  are  inflamed 

and  the  child  is  anxious  to  suck, 
to  get  another  woman 

to  suckle  it 
until  her  own  milk  again  becomes  good 

when  she  again  should  take  care  of  it  herself. 


I^ieuon-biefeiinltebcnnaifter  geft 

&as  be0  Wnbea  reebte  5ett 
5»  fefigenb  fy  5we  y  jar 

wte  bocb  cs  gar  bicfc  fiirwar 
/gntwenet  wirt  yon  milcbe  ee 

bie  nacb  fo  fagent  bie  imiiler  tnc 
©as  man  bas  Ktnb  entwenei  1  fol 

nocb  ™b  nocb  ba0  tb«t  jm  wol 

piuj 


Page  from  "Versehung  des  Leibs." 


482  PEDIATRICS  OF  THE  PAST 

It  is  essential  to  let  the  child  suck  moderately 

so  that  it  may  not  overdo  the  sucking. 
In  case  it  has  done  too  much  sucking, 

the  mother's  breast  should  be  withheld  from  the  child. 
For  great  harm  will  ensue 

if  it  has  sucked  too  much. 
But  the  sucking  is  also  beneficial; 

therefore  the  mother  must  often  drink  something. 

HOW  THE  CHILD  SHOULD  BE  KEPT  /  when  it  CUtS  its  t€€tb 

and  how  it  may  easily  learn  /  to  walk  and  to  talk. 

The  Mother: 

With  care  I  teach  my  child  to  walk  /  and  bring  it  up  in  every  virtue. 
Now  when  the  child  begins  to  cut  its  teeth  /  you  must  pay  attention  to 

them. 
For  teething  is  quite  painful  to  the  child.  /  Therefore  follow  my  advice: 
Should  the  teeth  hurt  the  child  beforehand  /rub  the  gums  well  enough 
with  chicken  fat  and  hare's  brains;  /  with  these  you  must  often  grease 

the  gums. 
If  they  then  should  become  chapped  /  you  must  relieve  the  child 
by  rubbing  its  gums  well  with  soap  and  honey.  /  One  more  advice  I  shall 

give  you  now : 
rub  its  neck,  /  throat  and  likewise  its  gums  with  violet  oil 
Wash  its  head  with  water  /  in  which  camomiles  have  been  boiled. 
You  must  give  the  child  delicate  and  light  food,  /  neither  too  hot  nor 

too  cold. 
Let  the  meat  be  tender  and  well  boiled;  too  much  of  it  is  not  good  for 

the  child. 
Boiled  or  fried  pears  /would  also  be  salutary  to  the  child. 
I  also  advise  you  honestly  /  to  chew  for  him  his  pap  and  bread. 
Feed  him  with  these  and,  in  addition,  with  bread  dipped  in  wine 
or  in  honey  or  pure  water.  /  Yet  you  must  not  overfeed  it. 
Then  when  it  starts  to  walk  /  you  should  do  your  best  to  help  it  along. 
Don't  be  in  a  hurry  at  the  beginning  /  so  that  no  harm  may  come  to 
the  child's  back  and  little  feet.  /  Should  it  appear  to  you  too  long  a  time 
before  it  learns  to  walk,  /  you  may  find  a  means  to  assist  it. 
Take  cabbage  stalks,  boil  them  well  /  in  water  and  wash  therein 
its  feet  as  well  as  its  legs.  /  That  you  should  do  at  night  and  in  the 

morning. 
Then  when  it  commences  to  talk  /  you  must  well  pay  attention 
that  it  be  taught  good  manners  and  conduct  /  in  its  early  youth. 
In  order,  however,  that  it  may  easily  learn  /  to  talk  you  must  pro- 
ceed as  follows: 


3fr  billcr  (bit  reiben 

nut  btngen  bic  id)  (c\)rcibm 
JObit  aucfcenfcbmalc5  -von  Ijennen 

mit  baumdll  bas  id)  beftenneti 
^ber  bafen  b^ne  gjitt 

wen  es  ben  billern  wol  tbfit 
&\ticn  wurc5en  maglta  nen 

vnb  barab  bem  fcmbc  gen 


Page  from  "Versehung  des  Leibs." 


484  PEDIATRICS  OF  THE  PAST 

Take  salt,  liquorice,  /  honey  and  incense; 
mix  them  well  all  together,  /  and  rub  his  tongue  with  it. 
By  this  means  speech  will  become  quite  easy  to  him,  /  and  he  will 
take  hold  of  it  all  the  sooner. 

at  times  it  happens  that  /  from  various  causes  the  Mother 

cannot  suckle  the  child  herself.  In  such  a  case  one  must 

choose  a  nurse  for  the  child.  Her  qualifications 

should  be  as  follows. 

The  nurse  must  be  of  shapely  stature,  /  not  too  young  and  not  too  old. 

She  must  at  all  times  be  free  /  from  illness  of  eyes  or  body. 

Moreover,  her  nature  must  be  such  /  that  there  is  no  defect  in  her  body. 

Mark  also,  that  she  must  be  /  neither  too  slim,  nor  too  plump. 

If  there  should  be  any  defect  in  her,  /  the  child  would  incline  towards  it. 

She  must  have  a  good  character,  /  modest,  chaste  and  clean. 

Her  food  should  be  in  conformity  with  the  following  directions,  /  so  that 

the  milk  may  remain  fully  nourishing. 
I  prescribe  her  to  eat  white  bread  and  good  meat,  /  also  rice  and  lettuce 
every  day.  Almonds  /  as  well  as  hazelnuts  /  she  should  not  do  without. 
Her  beverage  must  be  a  pure  wine;  /  and  moderation  must  be  used  in 

bathing. 
Nor  must  she  do  much  labor.  /  in  case  her  milk  should  give  out, 
she  must  not  forget  /  to  eat  peas  frequently  and  in  quantity, 
also  beans,  and  in  addition  gruel  /  which  should  be  boiled  in  milk 

beforehand. 
She  must  also  rest  and  sleep  a  good  deal  /  so  that  the  child  may  thrive 

on  the  milk. 
Moreover,  she  must  carefully  avoid  /  onions  and  garlic; 
as  well  as  any  bitter  or  sour  food  /  and  any  dish  containing  pepper. 
She  must  eat  no  oversalted  food  /  nor  anything  prepared  with  vinegar. 
Love's  intercourse  she  must  also  avoid  /  or  go  in  for  it  very  moderately. 
For  in  case  she  should  become  pregnant,  /  her  milk  would  be  harmful  to 

the  child. 
In  order  that  the  child  may  not  be  harmed  in  such  a  case,  /  one  must 

wean  it  from  the  milk. 

HOW  ONE  MUST  WEAN  THE  CHILD  FROM  THE  MILK  /  and  what  kind  of  food  / 

and  beverage  is  best  for  the  child. 

The  Mother: 

I  will  wean  my  child  /  and  take  care  of  it  as  well  as  I  can. 
Finally  I  will  tell  you,  forsooth:  /  When  the  child  has  drawn 
its  mother's  breast  in  the  second  year,  /  it  shall  then  be  weaned. 


To  trifle  bas  mir  ben  wol  geuah 
*Ds  man  es  a  foil  51I  lere  gen 

jn  ber  maifter  regimen 
^n  ben  fo  foil  man  es  nit  me 

baben  \il  ate  id)  feit  ce 
9  nb  foil  jm  grober  fpetfe  geben 

ben  bis  ber  ber  es  muge  Ieben 
©0  lang  bif  anffba^wolflte  jar 


Page  from  "Versehung  des  Leibs. 


486  PEDIATRICS  OF  THE  PAST 

But  this  must  not  be  done  too  quickly  /  and  the  child  must  be  given 

delicate  food  during  that  period. 
It  should  be  given  all  that  time  /  soft  drink  made  of  sugar, 
and  food  easily  digestible.  /  In  case  this  is  neglected, 
and  you  give  the  child  coarse  food  /  you  can  be  quite  sure 
that  it  will  be  affected  with  the  stone  /  and  with  convulsion  in  hands,  feet 

and  legs. 
In  hot  days,  however,  one  should  allow  the  child  /  to  draw  the  mother's 

breast  once  more. 
In  case  the  child  /  be  unwilling  to  give  up  the  mother's  breast  promptly, 
one  must  pound  some  myrrh  /  and  mix  it  with  crisp  mint; 
from  this  mixture  a  poultice  should  be  made  /  and  placed  on  the  mother's 

breasts. 
The  bitter  taste  of  the  poultice  /  will  make  the  child  lose  its  desire  for 

the  breasts. 
After  that  one  shall  give  the  child  a  moderate  quantity  /  of  food  and 

beverage  every  day. 
To  be  fed  frequently  with  small  quantities  /  of  food  and  drink  is  best 

for  the  child. 
Against  anger  and  fright  /  it  should  be  guarded  very  carefully. 
Sleep  is  very  wholesome  for  the  child.  /  Then  when  it  awakes  it  should  be 

at  once 
be  thoroughly  bathed,  /  after  which  it  should  exercise  a  little 
with  children's  play  or  other  pastime  /  before  it  gets  something  to  eat. 
A  short  time  after  that  /  it  should  get  some  food. 
One  should  give  the  child  wine  on  rare  occasions,  /  and  it  must  be  mixed 

with  water, 
because  unmixed  wine  is  harmful  to  the  child.  /  Here  my  advice  comes 

to  a  close. 

End  of  these  rules  of  behaviour. 

OTHER  PEDIATRIC  POEMS 

There  is  an  interesting  little  poem,  originally  written  in 
Italian,  by  Luigi  Tansillo  and  subsequently  translated  into 
English  by  William  Roscoe.  It  was  printed  in  London,  in  1798, 
and  reprinted  in  New  York  in  1800.  Tansillo  was  born  in  Nola, 
a  town  of  the  kingdom  of  Naples,  about  the  year  15 10.  He  came 
of  a  distinguished  family,  and  the  greater  part  of  his  life  was 
spent  in  the  profession  of  arms.  As  a  poet  and  a  soldier  he  made 
a  certain  impression  and  is  mentioned  in  Torquato  Tasso's 
dialogue,  "II  Gonzago."  Tasso  ranks  him  among  the  few  writers 
to  which  he  gave  the  appellation  of  leggiadro,  or  elegant.  One 


THE 

NURSE, 


POEM. 

TRANSLATED     FROM    THE     ITALIAN 


OF 


LUIGI    TANSILLO 


BY  WILLIAM  ROSCOE. 


LIVERPOOL, 

PRINTED   BV  J.  M'CREERY, 
TOR   CADELL   AND   DAV1ES,    STRAND, 

LONDON, 
1798^ 

Title  page  of  the  English  translation  of  "La  Balia. 


488  PEDIATRICS  OF  THE  PAST 

of  Tansillo's  first  compositions  was  a  poem  in  ottava  rima,  entitled 
"II  Vendemmiatore."  This  poem  is  in  keeping  with  the  spirit 
of  the  times.  He  also  wrote  a  pastoral  comedy  which  was  per- 
formed with  great  splendor  at  a  reception  given  by  his  bene- 
factor, Don  Garzia  di  Toledo.  In  addition,  he  turned  out  a  few 
lyrics  in  his  early  life.  All  of  his  writings  were  placed  in  the  "  Index 
Expurgatorius"  by  Pius  iv.  Another  poem  of  considerable  length 
is  entitled  "Le  Lagrime  di  San  Pietro"  (The  Tears  of  St.  Peter). 
Among  his  other  contributions  is  "II  Podere,"  (The  Country 
House)  in  which  he  gives  directions  for  choosing  a  country  seat. 
The  poem  in  which  we  are  particularly  interested  is  entitled 
"La  Balia"  (The  Nurse).  In  the  year  1767,  about  two  centuries 
after  the  death  of  the  author,  the  professor  of  literature  at  Vercelli, 
Giovan  Antonio  Ranza,  found  a  manuscript  copy  which  he 
published  with  copious  notes.  Tansillo  died  about  1569,  but 
other  historians  give  the  date  as  much  later.  Tansillo  was  regarded 
as  one  of  the  brightest  of  the  Italian  wits.  Roscoe,  in  his  com- 
ments on  "La  Balia"  states  that  "the  subject  is  in  a  high  degree 
interesting,  and  is  treated  in  a  manner  peculiarly  pointed  and  direct, 
yet  without  violating  that  decorum  which  is  due  the  public  at 
large,  and  in  particular  the  sex  to  whom  it  is  addressed." 

THE  NURSE 

Once  exird  from  your  breast,  and  doom'd  to  bring 
His  daily  nurture  from  a  stranger  spring, 
Ah  who  can  tell  the  dangers  that  await 
Your  infant,  thus  abandoned  to  his  fate? 
Say,  is  there  one  with  human  feelings  fraught 
Can  bear  to  think,  nor  sicken  at  the  thought, 
That  whilst  her  babe,  with  unpolluted  lips, 
As  nature  asks,  the  vital  fountain  sips; 
While  yet  its  pure  and  sainted  shrine  within 
Rests  the  young  mind,  unconscious  of  a  sin, 
He  with  his  daily  nutriment  should  drain, 
That  dread  disease  which  fires  the  wantons'  vein; 
Sent  as  the  fiercest  messenger  of  God, 
O'er  lawless  love  to  wave  his  scorpion  rod? 

Strange  is  the  tale,  but  not  more  strange  than  true, 
And  many  a  parent  may  the  treachery  rue, 
Who  for  their  child,  neglected  and  unknown, 


LA  BALIA. 

D'  Orfeo  vorrei,  che  fosse  ora  il  dir  miof 
Non  jierche  Vahna  ofifiressa  si  rileve; 
Ma  fier  darvi  a  veder  quel,  cK  io  desto. 

Pur,  se  7  vero  ha  laforza,  cfi  aver  deve 
Negli  animi  gentili,  come  7  vostro, 
Darlo  a  creder  a  voi  mi  sara  lieve. 

Ne  fier  deslo  d'  onor  verso  V  inchiostro, 
Ma  jier  un  zelo  santo,  e  naturale, 
Che  mi  muove  a  Jiieta  dell"  error  nostro ; 

E  so,  che  V  emendar  d'  un  s\  gran  male, 
O  Donne,  e  in  mano  a  voi,  qualor  vogliate ; 
Se  d5  adojirar  virtu  Jiunto  vi  cale. 

Vero  e,  che  questo  error  fu  in  ogni  etate ; 
Ma  in  nessuna  gia  mai,  quant'  ora  in  questa  ; 
Onde  maggior  ne  nasce  la  fiietate. 

Qualfuria  delV  inferno  all9  uom  fiiii  infesta 
Addusse  al  mondo,  e  tanto  crescerfece 
Usanza  coslfera,  e  disonesta  P 

Che  ftorti  Donna  nove  mesi,  o  diece 

In  ventre  iljiarto;  e  Jioiche  a  luce  e  tratto, 
Lo  tchifi,  ed  altra  Jirendalo  in  sua  vece. 

Quando  io  fienso  a  s\  cntdo,  orribil  atto ; 
E  che  dai  Jiiii  migliorjiiu  s'abbia  in  u$o, 
Nc  son  /ier  divenir  rabHoso,  o  muUo. 

A  page  of  "La  Balia." 


490  PEDIATRICS  OF  THE  PAST 

Receive  a  changeling,  vainly  deem'd  their  own. 
For  witness,  Ariosto's  scenes  peruse; 
— Who  shall  a  poet's  evidence  refuse? 
But  say  what  end  the  impious  fraud  secures? 
— Another's  child  thus  takes  the  place  of  yours. 
Meanwhile,  secure  the  crafty  dame  can  wait 
Her  ripening  project,  and  enjoy  the  cheat; 
Reap  for  her  son  the  fruit  of  all  your  toils, 
And  bid  him  riot  in  your  children's  spoils. 
Then,  hopeful  of  reward,  no  more  she  hides 
Her  guilt,  but  to  his  secret  ear  confides; 
Delighted  thus  a  double  boon  to  give, 
First  life  itself,  and  next  the  means  to  live. 

What  ceaseless  dread  a  mother's  breast  alarms 
Whilst  her  Iov'd  offspring  fills  another's  arms! 
Fearful  of  ill,  she  starts  at  every  noise, 
And  hears,  or  thinks  she  hears,  her  children's  cries 
Whilst  more  imperious  grown  from  day  to  day, 
The  greedy  nurse  demands  increase  of  pay. 
Vex'd  to  the  heart  with  anger  and  expense, 
You  hear,  nor  murmur  at  her  proud  pretence; 
Compell'd  to  bear  the  wrong  with  semblance  mild, 
And  sooth  the  hireling  as  she  sooths  your  child. 
— But  not  the  dainties  of  LucuIIus'  feast 
Can  gratify  the  nurse's  pamper'd  taste; 
Nor,  though  your  babe  in  infant  beauty  bright, 
Spring  to  its  mother's  arms  with  fond  delight, 
Can  all  its  gentle  blandishments  suffice 
To  compensate  the  torments  that  arise 
From  her  to  whom  its  early  years  you  trust, 
— Intent  on  spoil,  ungrateful,  and  unjust. 

CLAUDE  QUILLET 

Claude  Quillet  was  born  at  Chinon  in  1602.  Small  wonder  that 
he  became  a  poet.  Living  in  the  shadow  of  the  chateau  where,  in 
1428,  Jeanne  d'Arc  induced  Charles  vn  to  march  to  the  relief  of 
Orleans;  walking  the  streets  of  the  birthplace  of  Rabelais;  climb- 
ing the  sunlit,  vine-clad  hills  that  skirt  the  picturesque  Vienne, 
it  would  have  been  a  wonder  if  he  had  been  anything  else.  We 
know  little  about  him  but  that  he*  studied  medicine,  achieved 
success   and   through    certain   political   adventures,    gained  the 


THE  PEDIATRIC  POEMS  491 

enmity  of  the  all-powerful  Richelieu.  Readers  of  Dumas  will 
remember  the  following  quotation  from  the  beginning  of  "Les 
Trois  Mousquetaires": 

The  townsmen  always  armed  themselves  against  the  robbers,  the 
wolves  and  the  lackeys;  frequently  against  the  nobles  and  the  Hugue- 
nots; sometimes  against  the  King;  but  never  against  the  Cardinal  or 
the  Spaniard. 

Quillet  argued  in  his  capacity  of  physician  in  the  famous 
proces  of  Urbain  Grandier,  well  known  to  students  of  demonology 
and  one  of  the  causes  celebres  of  the  Church. 

Grandier  was  a  priest  of  ability  who,  through  the  power  of 
Jesuits,  was  given  a  church  in  Loudun  together  with  other  canon- 
ical favors.  Success  is  always  attended  with  enemies  and  instead 
of  bearing  his  honors  with  quiet  dignity,  he  flaunted  them,  and 
his  eloquent  tongue  was  not  idle  against  those  who  opposed  him. 
Accused  of  having  seduced  the  daughter  of  the  procureur  du  roi, 
he  was  condemned  to  bread  and  water  on  Friday  for  three  months, 
and  to  give  up  forever  his  church  duties  in  Loudun.  The  arch- 
bishop of  Bordeaux,  the  belligerent  Sourdis,  interfered  and 
swelled  with  pride,  Grandier  returned  to  Loudun  in  triumphal 
state,  even  bearing  laurel  leaves. 

There  was,  in  Loudun,  an  Urseline  nunnery  in  which  Grandier 
had  never  been.  Among  its  inmates,  were  relatives  of  Sourdis  and 
of  the  great  Richelieu.  The  Abbess  began  to  be  visited  by  a 
phantom  which  perched  on  the  foot  of  her  bed  and  otherwise 
tormented  her.  To  rid  her  of  this  devil  a  public  exorcism  was 
arranged  and  the  devil,  who  was  supposed  to  be  none  other  than 
Astaroth,  was  questioned,  and  affirmed  that  he  had  been  sent 
by  the  priest,  Urbain  Grandier.  Before  long  every  sister  of  the 
nunnery  was  possessed  of  a  devil  and  the  epidemic  spread  outside 
the  convent  walls  to  the  young  girls  of  the  village.  Though 
perfectly  innocent,  Grandier  was  confronted  by  his  accusers, 
condemned  to  be  burnt  at  the  stake,  which  sentence  was  carried 
out  in  1634. 

Quillet's  defense  availed  nothing  and  having  incurred  the 
enmity  of  those  in  power,  he  fled  to  Italy  where  he  took  orders 
and  eventually  became  secretary  to  the  French  ambassador, 
Marechal  d'Estrees.  When  the  news  of  Richelieu's  death  reached 
him,  he  returned  to  France,  where  Mazarin  made  him  Abbe  of 


492  PEDIATRICS  OF  THE  PAST 

Doudeauville.  Here  he  wrote  under  the  pseudonym  of  Calvidius 
Letus,  an  anagram  on  his  name.  In  1655,  he  published  at  Leyden, 
"Callipaedia  seu  de  Pulchrae  Prolis  Habendae  Ratione";  "The 
Way  to  have  Handsome  Children,"  as  the  translator  of  the  English 
edition  puts  it.  This  pediatric  poem  was  popular  and  has  been 
done  into  French  many  times;  among  the  translations  are  Mon- 
thenaut,  1749;  Lancelin  de  Laval,  1774;  Caillau,  1799;  and 
Comas  Doras,  1832.  The  English  translation  was  published 
anonymously  at  London  in  1710,  and  is  inscribed  to  Dr.  Garth. 
The  same  volume  contains  "  Paedotrophia,"  by  Sainte  Marthe. 
One  paragraph  of  the  dedication  may  be  quoted : 

Whether  bis  and  St.  Marthe's  knowledge  oj  Physick  and  Medicine  be 
Just  and  Considerable,  I  leave  to  you,  Sir,  and  the  Gentlemen  oj  the  College, 
to  determine;  if  I  have  done  my  Authors  any  Injury  therein  I  cou'd  not 
help  it.  You  are  your  selves  in  some  wise  to  blame,  since,  if  you  bad  under- 
taken to  make  'em  English,  none  oj  us  woud  have  dard  to  have  attempted  it: 
And  if  you,  Sir,  especially  bad  bad  Leisure  and  Disposition  to  have  done 
it,  my  Originals  woud  have  bad  little  more  than  the  Merit  oj  imperject 
Copies;  so  much  greater  is  your  Mastery  in  one  Art,  and  your  Genius 
in  the  other. 

The  Callipaedia  starts  out  with  an  invocation,  as  all  verse 
of  the  kind  should;  it  needs  no  comment. 

I  Sing  the  Pleasures  of  the  Nuptial  Bed, 
And  the  fair  Product  of  the  Genial  Seed, 
What  Skies,  propitious  to  the  dear  Embrace, 
Imprint  their  Brightness  on  a  beauteous  Face; 
How,  in  one  happy  Object,  we  may  find 
A  charming  Body  with  a  lovely  Mind; 
How  the  glad  Parents,  when  the  Boy  is  born, 
With  shining  Virtues  may  his  Soul  adorn. 

Ye  Goddesses,  who  move  and  melt  the  Heart, 
Ye  Graces,  to  the  Muse  your  Gifts  impart; 
And  Thou,  their  Queen,  who  on  th*  Idalian  Hill 
With  Rapture  didst  the  Phrygian  Shepherd  fill, 
Whose  naked  Beauties  blest  his  greedy  Eyes, 
And  with  full  Justice  gain'd  the  Golden  Prize; 
Inspire  my  Song,  and  teache  me  to  rehearse 
The  Cause,  the  pow'r  of  Love,  in  grateful  Verse. 
Good  Wives,  perhaps,  will  to  my  Rules  attend, 
By  tender  Husbands  taught,  who  can't  offend; 


CL.   QVILLETI 

CALLIPAEDIA, 

SEV 

DE  PVLCHRAE  PROLIS 

HABENDAE  RATIONE, 

POEMA  DIDACTICON. 

CVM   VNO   ET  ALTERO 

EIVSDEM  AVTORIS   CARMINE. 

1VXTA  EXEMPLAR  EXCVSVM. 


P  A  R  I  S  I  I  S, 
Apiid  T  H  O  M  A  M  JOLY. 

M.  DCC.  IX. 


Title  page  of  "Callipaedia. 


494  PEDIATRICS  OF  THE  PAST 

She'll  listen  to  my  Lays,  whose  pious  Pray'r 
Pleads,  that  the  promis'd  Issue  may  be  fair. 
Let  Men  no  more  the  Nuptial  Fruit  despise, 
Nor  view  the  crooked  Babe  with  loathsome  Eyes. 
No  more  let  Hymeneal  Joys  be  curst, 
Nor  Forms,  ill  Shap'd,  with  hated  Care  be  Nurst. 

You,  who  for  Beauteous  Sons  and  Daughters  pray, 
My  Precepts  hear,  and  what  you  hear,  obey. 
And  if  the  Poet's  Lessons  you  allow, 
Crown,  in  return,  with  Myrtle  Wreaths  his  Brow. 

The  author  goes  on  to  state  that: 

When  Sov'reign  Jove  from  High  Olympus  view'd 
The  Race  of  Men,  and  saw  their  Ways  were  good. 

Evidently  men  behaved  differently  in  those  days;  be  that  as 
it  may,  Jove  contrived  a  nymph  of  wondrous  perfection  to  give 
to  man.  From  the  description  she  could  have  graced  a  Sunday 
supplement  or  the  cover  of  a  magazine  in  these  degenerate  days. 
Jove  called  her  Pandora  and  gave  her  his  orders: 

Go,  lovely  Nymph,  to  whom  the  Gods  gave  Birth, 

And  bless  with  gracious  Looks  th'  Obedient  Earth. 

Conspicious  shall  they  Form  consummate  shine, 

And  Man's  poor  Beauty  be  enrich'd  by  Thine. 

Go,  while  the  happy  Age  from  Guilt  is  free, 

Fair  Nature  fairer  shall  commence  by  Thee. 

But  if  the  Pleasure  of  Mankind's  thy  Care, 

If,  as  thou'rt  form'd,  thou  would'st  be  ever  fair, 

The  Box  I  give  thee  full  of  fatal  Seed, 

With  a  light  Finger  to  unlock,  take  heed. 

Thy  Disobedience  will  for  Vengeance  call, 

And  Plagues  on  Thee,  as  well  as  Them,  will  fall. 

She  was  advised  of  men  and  for  a  time  all  went  well, 

But  when  the  guiltless  Age  to  Change  began, 

And  devious  were  the  Mind  and  Ways  of  Man, 

When  his  whole  Race  the  foul  Infection  seiz'd. 

And  Violence  and  Lust  fill'd  ev'ry  Breast, 

Pandora  curst  whom  she  before  had  blest. 

She  grows  Corrupt,  the  more  deprav'd  they  grew, 

Pursues  the  wicked  Paths  the  World  pursue. 

And  scorning  Heav'ns  Supream  Commands,  unlocks, 

Profanely  Curious,  the  forbidden  Box. 


THE  PEDIATRIC  POEMS  495 

The  transmission  of  hereditary  disease,  of  infections  and 
the  like  is  grimly  pictured  and  might  well  be  included  in  the 
pamphlets  a  paternal  government  sends  out  to  its  sinful  children. 

You  now,  who  are  dispos'd  to  learn  our  Arts, 

Imprint  this  useful  Lesson  on  your  Hearts. 

Not  all  of  either  Sex  by  Hymen  join'd, 

Are  always  apt,  or  shou'd  encrease  their  Kind. 

Ne'er,  when  the  Body  is  defil'd,  presume 

Within  the  Temple  of  God  to  come, 

Who  without  Horror  hears  the  Fable  tell 

Of  Pluto's  Rapes,  and  the  Amours  of  Hell. 

What  Virgin  cou'd  a  Polypheme  behold, 

And  the  foul  Monster  in  her  Arms  enfold. 

No  Vulcan  ought  a  Venus  to  caress, 

Nor  her  fair  Breasts  with  filthy  Fingers  press. 

Such  Wretches  shou'd  provoke  no  Virgins  Fears, 

But  end  in  real  Flames  their  Steril  Years. 

Nor  those  who  have  too  long  delay'd  to  Wed, 

Shou'd  taste  the  Pleasures  of  the  Marriage-bed, 

If  seiz'd  with  Impotence,  before  they  prove 

The  pleasing  Combats  of  Connubial  Love. 

Nor  those  whom  Gout  or  racking  Stone  devour, 

Nor  such  as  dread  an  Epilepsy's  Pow'r, 

Nor  those  who're  eaten  up  with  Cank'ring  Spleen, 

Nor  such  as  tickling  Ptisicks  waste  within, 

Nor  those  whose  Veins  are  full  of  Fev'rish  Blood, 

Nor  when  Consumptions  drein  the  Vital  Flood; 

For  if  the  Generative  Seed's  defil'd, 

The  Father's  Hurt's  transmitted  to  the  Child. 

Ill  Habits  and  Diseases  thus  are  nurst 

In  the  weak  Frame,  and  he  with  Life  is  curst. 

How  often  have  I  heard  such  Infants  Cries 

Rend,  with  their  fruitless  moan,  the  guiltless  Skies. 

You  then,  who  covet  Hymeneal  Joys, 

Consider  well  before  you  fix  your  Choice. 

And  when  your  Choice  is  fix'd,  with  equal  care 

Of  Bliss  dishonest,  and  ill-tim'd,  beware, 

Who'd  stain  his  Issue  that  cou'd  have  it  fair? 


On  eugenics  has  anything  more  apt  been  writ  than  these 
ines? 


496  PEDIATRICS  OF  THE  PAST 

As  well  as  sound,  the  Lover  shou'd  be  strong, 

And  never  to  the  Wrinkled  wed  the  Young. 

A  Youth  ne'er  couple  to  a  Wife  decay'd, 

Nor  to  a  Cripple  match  a  blooming  Maid. 

For  ne'er  the  Genial  Pleasure  will  they  tast, 

In  vain  the  Youth's  carest,  the  Maid  Embrac'd. 

The  Furies  follow  such  unequal  Vows, 

And  fill  with  endless  Plagues  the  jarring  House  .    .    . 

Where  Beauty's  wanting,  Youth  has  often  Charms, 
Where-ever  Youth  is  wanting,  nothing  warms; 
For  Juiceless  Age  do's  youthful  Sap  destroy, 
And  wears  and  wastes  the  Strength  it  can't  enjoy. 

The  marriage  of  either  sex  to  the  wealthy  old  misers  of  the 
appetite  is  pictured  in  no  uncertain  terms,  the  spurious  off- 
spring and  the  meanderings  are  vividly  described;  the  mating  of 
the  very  young  is  deplored,  but  his  age  limit  for  the  fairer  sex 
is  certainly  no  strict  one. 

Twelve  Springs  compleat,  before  she  thinks  to  wed, 
Their  Vernal  Bloom  must  in  the  Virgin  shed. 

The  second  book  deals  with  the  proper  conduct  of  the  marriage 
bed,  starting  from  the  nuptial  rites;  rules  for  ensuring  fair  issue 
are  given. 

If  Meats  thy  Belly  fill,  or  Fumes  thy  Head, 
Defer  the  Raptures  of  the  Nuptial  Bed. 
When  indigested  Meats  thy  Stomach  load, 
Delay  thy  Off'ring  to  the  Marriage  God   .    .    . 
This  Lesson  will  to  Lovers  seem  severe, 
But  practis'd  well,  their  Issue  shall  be  fair. 

The  effect  of  the  stars  naturally  comes  in  for  a  share  of  the 
attention,  but  the  author  hurries  on  to  a  meeting  called  together 
by  Jove  to  consider  the  decay  of  the  beauty  of  the  race;  the 
passion  for  investigating  committees  is  no  new  one.  Apollo 
explains  the  matter: 

Man  has  ye  Deities,  contemn'd  the  Skies, 
And  scorn'd  the  Stars  that  teach  him  to  be  wise: 
The  rolling  Spheres  revenge  his  Impious  Scorn, 
Hence  horrid  Boys  and  hateful  Girls  are  born. 


THE  PEDIATRIC  POEMS  497 

As  from  my  Heav'n  the  shining  Orbs  impend, 
This  Planet  is  a  Foe,  and  that  a  Friend. 
'Tis  mine,  or  Strength,  or  Beauty  to  bestow, 
Which  few  have  known,  and  fewer  wish  to  know; 
Where  Heav'n  is  by  the  Oblique  Zodiack  bound, 
Twelve  starry  Signs  perform  their  destin'd  Round. 
Hence  ev'ry  Beauty  rises,  ev'ry  Grace, 
Hence  ev'ry  Vice  and  Blemish  of  the  Face. 

The  exact  effect  of  each  sign  of  the  Zodiac  is  fully  explained; 
a  lesson  in  anatomy  and  physiology  follows,  to  be  succeeded  by  a 
lesson  on  the  determination  of  sex.  The  doctrine  of  the  Vienna 
obstetrician,  Schenck,  was  based  on  diet;  a  lean  diet  produces 
boys,  a  rich  one,  girls.  This  idea  is  embalmed  in  the  nursery 
rhyme: 

What  are  little  boys  made  of? 
What  are  little  boys  made  of? 
Snaps  and  snails  and  puppy  dog  tails, 
That's  what  little  boys  are  made  of. 
What  are  little  girls  made  of? 
What  are  little  girls  made  of? 
Sugar  and  spice  and  all  things  nice, 
That's  what  little  girls  are  made  of. 

Abbe  Quillet  recommends  "white  meals"  (whatever  they 
may  be)  for  males.  Read  also  this  heresy: 

Sufficient  for  the  Nuptial  Joy's  the  Vine, 
And  lusty  Boys  are  got  by  gen'rous  Wine. 
But  most,  Oh  Bur  gundy  I  thy  Nectar  warms 
Their  Hearts,  and  burnishes  their  Bridal  Arms. 
Both  bright  Champagne  with  equal  Vigour  fills, 
And  the  rich  Cluster  of  the  Aisian  Hills. 

And  you,  ye  Wives,  who  with  your  Husbands  join, 
To  pray  for  Sons  to  prop  an  Ancient  Line, 
At  Meals,  with  sparkling  Wine  rejoice  your  Souls, 
And  freely  pledge  'em  in  their  modest  Bowls. 

Against  excess  he  warns,  giving  various  dangers  and  ends. 

Let  Reason  in  your  Cups  direct  your  Draught 
The  Ship  is  often  sunk  when  over  fraught. 


498  PEDIATRICS  OF  THE  PAST 

The  planetary  influence  comes  in  again. 

When  the  Ram  rules,  or  when  the  Lion  shines, 
Or  when  the  Ballance,  Centaur,  or  the  Twins, 
Or  when  the  Radiant  Urn  its  Light  displays, 
A  Boy  expect  to  crown  the  close  Embrace. 
The  rolling  Planets  are  to  Males  inclin'd, 
As  in  the  Lessons  of  the  Learn'd  we  find. 
Thus  Saturn,  furious  Mars,  and  Sov' reign  Jove, 
Reward  with  Boys  the  Parents  faithful  Love. 

The  hygiene  of  pregnancy  is  outlined  and  the  old  fallacy  of 
material  impression  hymned. 

As  when  the  Wheaten  Mass  is  work'd  to  Dough, 

Or  swells  with  Leaven  in  the  Kneading-Trough, 

It  takes  whatever  Marks  the  Maker  gives, 

And  from  the  Baker's  Hand  its  Form  receives. 

So  works  the  Fancy  on  the  Female  Mold 

And  Women  shou'd  beware  what  they  behold. 

Nor  New  is  the  Remark,  of  Old  we  find, 

That  Births  were  thus  affected  by  the  Mind. 

As  from  without  an  Object,  fair  or  foul, 

With  Terror,  or  with  Pleasure,  struck  the  Soul  .    .    . 

Since  by  foul  Objects  filthy  Births  are  made, 
And  the  vile  Picture's  to  the  Womb  convey'd, 
A  pregnant  Wife  will  ne'er  behold  a  Whale, 
Nor  Porpus,  nor  the  Dolphin's  Azure  Scale. 
Nor  thee,  Oh  Proteus,  will  she  see,  nor  you 
Tritonian  Monsters,  while  she's  Teeming,  view; 
But  let  her  on  the  lovely  Nereids  gaze, 
And  fix  her  Eyes  on  ev'ry  charming  Face. 

Ye  Pregnant  Wives,  whose  Wish  it  is,  and  Care, 
To  bring  your  Issue,  and  to  breed  it  Fair, 
On  what  you  look,  on  what  you  think,  beware. 
A  Boy  your  Wish,  a  beauteous  Boy  behold, 
With  Lips  a  Cherry  red,  and  Locks  of  Gold; 
Like  him  for  whom  Alexis  sigh'd  of  old. 
Or  in  Apollo* s  Radiant  Youth  delight, 
And  like  Apollo,  shall  the  Birth  be  bright. 

If  Female  Fruit  you  rather  covet,  view 
A  Heav'nly  Venus,  such  as  Titian  drew. 
Or  beauteous  Danae,  when  her  Virgin  Flow'r 


THE  PEDIATRIC  POEMS  499 

By  Jove  was  gather'd,  in  the  Golden  Show'r. 
But  if  the  Beauties  of  our  Age  can  please, 
Fair  Phyllis  view;  for  she's  as  Fair  as  these. 

The  avoidance  of  extreme  exertion  and  dancing  on  the  one 
hand  and  the  evils  of  extreme  idleness  on  the  other,  are  cleverly 
managed.  And  now  the  author  turns  aside  to  pay  his  compliments 
to  Sainte  Marthe: 

What  Med'cines  will  Relieve,  and  what  will  Cure, 

A  Sickness  that's  as  fatal  as  impure, 

Who  dares  pronounce  on  the  Pierian  Hill? 

The  Secret's  left  to  Aisculapian  Skill. 

And  who,  that  ever  read  thy  Verse  Divine, 

Thou  Great  St.  Marthe,  will  e'er  be  pleas'd  with  mine? 

What  thou  has  Sung  shall  I  presume  to  Sing? 

Who'll  dip  the  Stream,  when  they're  so  near  the  Spring? 

All  Infant's  Plagues  they'll  from  thy  Lessons  know, 

And  what  the  Cure,  and  whence  the  Causes  flow. 

Thy  wise  Instructions  let  'em  wisely  weigh, 

Oft  read  thy  Rules,  and  what  they  read,  obey. 

All  Helicon  thy  sacred  Science  drains, 

And  Pindus  now  a  barren  Hill  remains. 

For  thee,  the  Delpbick  God  exhausts  his  Store, 

And  we  can  nothing  in  thy  Art  explore. 

The  fourth  and  last  book  deals  with  the  education  of  the 
child,  the  chief  part  as  the  author  puts  it. 

What  barb'rous  Sloth  my  sluggish  Soul  has  seiz'd, 
And  by  what  Lazy  Pow'r  am  I  possest? 
Will  Phoebus  ne'er  again  the  Muse  inspire, 
And  ever  will  she  leave  Unstrung  her  Lyre? 
Fair  Faces  and  fine  Limbs  have  try'd  her  Streins, 
But  the  chief  Part  that  crowns  our  Work  remains. 

The  author  is  a  pleasant  sort  of  pessimist,  as  the  following 
lines  attest: 

Bright  in  the  Image  of  his  Maker  born, 

The  Mortal  on  his  Fortune  looks  with  Scorn. 

His  base  Original  he  proudly  hates, 

The  Gods  he  Curses,  and  the  guiltless  Fates; 

That  Naked  from  his  Mother's  Womb  he's  thrown: 


5oo  PEDIATRICS  OF  THE  PAST 

And,  of  all  Births,  he  most  abhors  his  own. 

What  profits  me  the  Flame  my  Sire  might  steal, 
The  Etherial  Vigour  in  my  Breast  I  feel? 
What  profits  me  my  Godlike  Mind,  he  cries, 
A  Soul  aspiring  to  its  native  Skies? 
What's  the  poor  Life  the  Gods  are  pleas'd  to  grant, 
If  they  have  doom'd  me  to  Eternal  Want? 
What  Cov'ring  but  the  Sky,  what  Bed  but  Earth, 
Had  Nature  to  receive  me  at  my  Birth? 
Ign'rant,  and  Infants,  by  our  cries  we  shew, 
As  soon  as  we  are  Born,  that  'tis  to  Woe. 

The  evils  of  putting  infants  under  the  care  of  others  is  touched 
on,  and  the  danger  of  infection  mentioned,  and  the  old  error 
about  the  milk  affecting  the  disposition  of  the  child,  again  put  in 
verse. 

We  never  can  enough  those  Parents  blame, 
Who,  careless  of  a  Mother's  sacred  Name, 
To  Ign'rant  Nurses  their  poor  Infants  trust; 
To  such,  as  neither  will  nor  can  be  Just. 
Oft  at  a  Venal  Pap  they  suck  their  Bane, 
And  in  their  Blood  the  Latent  Plague  retain. 
But  of  those  Evils  not  to  speak,  which  flow 
From  the  first  Draughts,  and  with  the  Body  grow; 
The  Mind's  affected  by  corrupted  Juice, 
If  bad  the  Milk,  the  Manners  may  be  loose. 
Who  knows  not  that  a  Whore's  malignant  Pap 
Corrupts  the  Infant,  in  her  wanton  Lap; 
With  Lust  and  impious  Fires  it  fills  his  Breast, 
And  seldom  is  the  Child,  so  suckled,  Chast. 

The  remainder  of  the  poem,  perhaps  in  some  ways  the  most 
interesting  part,  need  not  detain  us.  It  is  given  over  to  education 
and  the  like.  The  subject  of  travel  as  a  means  of  instruction 
affords  the  author  an  opportunity  to  do  some  clever  delineation 
of  the  more  salient  characteristics  of  the  various  European 
nations.  Some  of  the  lines  are  remarkable  and,  even  at  the  risk 
of  digressing  further  than  usual,  may  be  quoted. 

The  author  advises: 

Take  from  their  Manners  what  for  them  are  fit, 

Each  Province  has  its  Ways,  each  People  have  their  Wit. 


THE  PEDIATRIC  POEMS  501 

Some  of  the  characterizations  follow: 

Their  ancient  Courage,  and  their  Strength  declin'd, 

The  wily  Ways  of  subtle  Manners,  and  their  Language  sweet. 

Their  flowing  Eloquence,  and  fiatt'ring  Air, 

Are  find,  if  false,  and  if  deceitful,  fair. 

For  ev'ry  Art  th'  Italians  are  renown'd, 

And  sweet's  their  Science  when  'tis  not  profound. 

Thy  Travels  if  by  Spain  thou  dost  pursue, 

A  haughty  Nation,  and  a  fierce,  thou'It  view;  .    .    . 

Their  Courage  constant,  and  their  Martial  Flame 
Still  Blazes,  and  with  them's  no  Vice  like  Shame  .    .    . 

A  Lordly  Spirit  burns  in  ev'ry  Breast, 
And  gladly  they  for  Rule  renounce  their  Rest  .    .    . 
Tenacious  of  their  Secrets,  close  and  proud; 
Religion  they  pretend,  to  cheat  the  Crowd. 
Thus  vulgar  Minds  with  Biggot  Zeal  they  fill, 
Thus  colour  their  Designs,  and  cloak  when  ill. 

A  Nation  temper'd  of  a  various  Kind, 

And  Mild  and  Fierce,  and  Rude  and  Gentle,  join'd. 

Good  Offices,  or  ill,  pass  lightly  by, 

And  neither  long  in  their  Remembrance  lye  .    .    . 

Their  Native  Levity  to  Valour  yields, 

And  none  more  fierce  or  bold  in  Fighting  Fields  .    .    . 

Not  only  civil  Manners,  free  Access, 
Not  chearful  Looks  alone,  and  fine  Address, 
The  French  distinguish;  but  the  Muse  Divine, 
And  gen'rous  Arts  with  those  of  Sway  they  join. 

At  Calais  if  you  cross  the  Streight,  you'll  find 
The  cruel  English  from  the  World  dis join'd. 
Cruel  indeed,  with  Royal  Blood  defil'd, 
A  Rabble,  Rash,  Untameable,  and  Wild. 
With  holy  Lunacy  they're  all  possest, 
And  ev'ry  Man's  a  Prophet,  or  a  Priest. 
Humour's  with  them  Religion's  only  Guide, 
And  each  that  fatal  Rule  pursues  with  Pride. 
Each  of  his  Neighbor  wou'd  his  own  impose, 
And  thence  This  Sect  to  That  are  Mortal  Foes. 


502  PEDIATRICS  OF  THE  PAST 

Hence  Wars  and  Woes,  while  each  his  Dream  wou'd  spread, 

Mis-lead  the  rest,  as  he's  himself  mis-led. 

Each  by  the  Sword  his  Doctrine  wou'd  defend, 

Which  each  believes  he  has  a  Right  to  mend. 

To  Kings  alike  Rebellous,  and  the  Skies, 

All  Ancient  Rites  and  Worship  they  despise. 

Plain  are  the  People,  Faithful  here,  and  Kind. 

And  fair  themselves,  they  hate  a  fraudful  Mind. 

But  whether  'tis,  that  thick  and  cold  the  Air, 

The  Brain  is  chill'd,  a  ready  Wit  is  rare 

Or  whether  'tis  that  by  the  Vice  of  Drink, 

They  drown  their  Wit,  and  lose  the  Pow'r  to  think   .    .    . 

Thus  to  the  Gods  their  Noisie  Hymns  they  sung, 
And  the  Lewd  Temples  with  their  Clamour  rung  .    .    . 

Who  more  Discov'ries  have  in  Science  made, 
Who  more  its  Use  Advanc'd,  its  Glory  spread? 
The  Lightnings  of  the  War,  who  do's  not  know, 
And  Thunders  we  to  German  Studies  owe. 


SAINTE-MARTHE 

Certain  families  have  a  talent  for  writing  and  it  runs  through 
several  generations.  Gaucher  n,  Sainte-Marthe,  commonly  called 
Scevola,  came  from  such  a  family,  of  the  French  noblesse  of  the 
sixteenth  and  seventeenth  centuries.  His  father,  Gaucher  i,  was 
a  man  of  parts,  physician  in  ordinary  to  Francois  i.  His  brother 
Charles,  a  poet  of  renown  in  his  day,  was  showered  with  honors 
by  Margeurite  de  Valois.  Scevola  was  born  in  Loudun  in  1526, 
and  became  Chevalier  Seigneur  de  Corbeville,  dean  of  the  Court 
of  Aides,  and  guardian  of  the  library  of  his  Majesty,  at  Fontaine- 
bleau.  One  of  his  sons  was  afflicted  with  some  serious  malady 
during  the  period  of  nursing  and  the  most  clever  physicians  were 
employed  to  help  it.  Their  efforts  were  useless  and  his  cure  was 
despaired  of.  As  Sainte-Marthe  was  a  good  father  and  a  good 
doctor,  he  then  took  the  cure  upon  himself  and  made  researches 
into  the  application  of  everything  pertaining  to  the  nature  of 
infancy,  both  the  most  curious  and  the  most  savant.  He  pene- 
trated even  into  the  very  depths  of  the  secrets  of  Nature  and 
happily  snatched  the  infant  from  the  arms  of  death.  He  was 


THE  PEDIATRIC  POEMS  503 

begged  to  preserve  for  posterity  his  curious  researches  and  in 
order  to  present  them  in  the  most  agreeable  manner  he  com- 
posed a  poem  in  Latin,  entitled  "La  Paedotrophia,"  which  he 
had  printed  in  1584  and  dedicated  to  Henry  in,  King  of  France 
and  of  Poland.  The  poem  was  translated  into  English  verse 
and  printed  in  London  in  1710,  along  with  the  translation  of 
"Callipaedia,"  by  the  Abbott  Quillet. 

Most  of  his  time  seems  to  have  been  devoted  to  government 
administration,  to  which  by  nature  he  seemed  to  have  been  par- 
ticularly adapted.  He  was  treasurer  of  France  at  Poitiers  in  1579 
and  deputy  in  the  Etats  de  Blois  in  1588.  He  allied  himself  against 
the  Ligueurs,  retired  to  Tour  and  eventually  contributed  to  the 
submission  of  Poitiers  in  1 594.  He  died  at  Loudun  and  his  funeral 
oration  was  delivered  by  Theophraste  Renaudot,  physician  to  the 
King,  well  known  as  the  founder  of  the  first  French  newspaper, 
Gazette  de  France.  His  twin  sons  became  celebrated  historians. 

Sainte-Marthe  was  a  poet  of  no  mean  ability,  and  his  works 
were  highly  esteemed  by  his  contemporaries.  Indeed,  their 
popularity  has  been  a  matter  of  wonder.  "Paedotrophia,  or  the 
Art  of  Nursing  and  Rearing  Children,' '  was  reprinted  many 
times.  His  other  poetical  Oeuvres,  consisting  of  elegies,  epigrams, 
sylves  and  metamorphoses,  were  published  at  Paris  in  1569  and 

"Paedotrophia,  or  the  Art  of  Bringing  Up  Children,"  is  a 
poem  in  three  books.  In  the  English  translation,  it  is  a  little  over  a 
hundred  pages  long.  It  starts  off  with  an  invocation  to  the  Muses 
and  Phoebus: 

Tho'  Sacred  Nymphs,  you're  free  from  fond  Desires, 
And  feel  no  Flame  but  pure  Immortal  Fires; 
Tho'  Virgin  Pleasures  are  your  sole  Employ, 
And  never  can  you  know  the  Marriage  Joy; 
Nor,  when  the  smiling  Infant's  born,  can  prove 
A  Parent's  pious  Care,  a  Mother's  Love; 
Ye  Nine,  who  haunt  the  sweet  Aonian  Spring, 
You  I  invoke,  nor  dare,  without  you,  Sing. 
A  Theam  proportion'd  to  my  Strength  I  chuse, 
A  Child's  the  Subject  of  my  humble  Muse. 
While  from  the  Cradle,  I,  in  lowly  Lays, 
Teach  how  to  feed  the  Babe,  and  how  to  raise, 
'Till  its  loose  Joints  are  knit,  its  Art'ries  strong, 


PiEDOTROPH  II  A 5 

O  R, 

THE    ART    OF 
NURSING  and  REARING  CHILDREN. 

A  POEM,    IN   THREE    BOOKS. 
Tranflatcd  from  the  Larm  of 

SCEVOLE  DE  ST.  MARTHE. 


With  Medical  and  Hillorical  Notes ;  with  the  Life  of  Cue 
Author,  from  the  French  of  Michfl  and  Nice«;ow; 
his  Kpitaph  ;  his  Dedication  of  this  Poem  to  Henrv  (II. 
of  France  ;  and  the  Epigram  writtcii  on  the  vilit  he 
had  the  Honour  to  receive  from  Charles  I.  of  Eng« 
land,  whenpR:Nc£OF  Wales. 


By  H.  W.  TYTLER,  M.D. 

Tranflator  of  Cali.imachUs,  and  Fellow  of  the  Society  for  the 
Encouragement  of  Arts,  Manufactures,  and  Commerce. 


FoJ  S^MMARTHAXI  t/svirta  poem/it  a  en  Ira 
Pertraclate  nifinuy  Jot!  of  que  tvcli/itt  chirtat ; 
Ifu  titas  Htliconis. aquas \  hie  Jt*mi>:a  i'indi 
lota  b.iujit ;   nullam  non  ntrvit  Afoliini;  a>  tun. 


ftl'iLLfT 


LONDON; 

tVifltfn^  fot  the  Author,  hy    Jon?*  Nichols,   Red- Lion- ( 
paifege:  And  (by  hy  J.  Dkcuett,  Piccadilly ;  J.  Mukkav 
nndS.  Hr«;iiLtY,  F'.eet-rtreot  t  T.  N.  Lonoman,  Patcr-uoiUv* 
row j    BfTLt.  and  HnA»fi'T£,  Edinhurghj  and  by  all  the 
principal  ikokfcllcri  in  Great -Iiriiain. 

w.ucc.xcy:!. 


Title  page  of  the  English  translation  of  "Paedotrophia.1 


THE  PEDIATRIC  POEMS  505 

And  the  grown  Youth  forbids  my  forward  Song. 
Thou  by  whose  Genial  Heat  all  Nature  lives, 
And  Grace  and  Vigour  from  the  Beams  receives, 
Thy  Vital  Warmth  into  my  Verse  infuse, 
My  Labours  crown,  and  animate  the  Muse. 
Thee  Phoebus,  Father  of  the  tuneful  Throng, 
Accept  my  willing  Vow,  and  own  my  Song. 

The  salient  features  of  rearing  children  are  given  in  no  uncer- 
tain terms.  On  the  value  of  maternal  nursing  he  says : 

Twas  a  Sage  said  it,  and  the  Saying's  good, 
The  Mother's  Milk's  the  only  wholesome  Food. 
Large  Meals  upon  the  Sucking  Babe  bestow, 
And  freely  let  the  Snowy  Fountains  flow  .    .    . 
Life's  fed  with  Life  itself,  and  Blood  with  Blood. 
From  Hers  it  circles  thro'  its  little  Veins, 
And  growing  Strength  in  ev'ry  Part  maintains. 
Have  you  not  heard  it  in  the  Cradle  cry, 
And  seen  the  ready  Nurse  to  feed  it,  fly? 
How  soon  it  Laughs  to  see  the  swelling  Breast, 
Seizes  the  Nipple,  and  returns  to  Rest? 

Prenatal  care  or  puericulture,  the  vaunted  discovery  of  this 
or  that  society,  comes  in  for  its  share  of  attention  and  what  is 
written  might  grace  the  propagandic  literature  of  the  day;  only 
the  mother  would  be  asked  to  learn  not  from  the  Muse,  but  to 
the  glory  of  the  particular  group  of  advanced  thinkers  putting 
out  the  pamphlets. 

Learn  of  the  Muse,  and  may  thy  Pains  succeed. 
Don't,  'till  'tis  Born,  defer  thy  Pious  Care; 
Begin  betime,  and  for  its  Birth  prepare. 

Among  other  things  compare  this  with  the  present-day  tracts: 

Let  neither  Grief,  nor  Fear,  nor  boundless  Joy, 
The  Peace  and  Vigour  of  thy  Mind  destroy. 
Live,  if  thou  canst,  at  Ease,  and  void  of  Care, 
And  neither  riot  in  thy  Sleep,  nor  spare. 
Refresh  thy  weary  Limbs  with  sweet  Repose, 
And  when  fatigu'd  thy  heavy  Eye-lids  close. 
But  never  let  thy  Slumbers  last  too  long, 
Enough  is  right,  but  all  beyond  is  wrong. 
As  Rest  from  Labour,  Labour  flies  from  Rest, 


5o6  PEDIATRICS  OF  THE  PAST 

And  with  their  mutual  Helps  they  both  are  blest. 

Yet  Sleep  too  much  Indulg'd  besots  the  Brains, 

And  fills  with  Vicious  Blood  the  Stagnant  Veins. 

Ill  Humours  it  creates,  and  by  its  Weight 

Suppresses  and  consumes  the  living  Heat  .    .    . 

First  then,  be  careful  how  your  Meats  you  chuse, 

And  chosen  well,  with  Moderation  use. 

With  too  much  Food  your  Stomach  ne'er  oppress, 

And  let  it  as  'tis  richer,  be  the  less. 

A  weak  Digestion  can't  a  Burthen  bear, 

And  to  your  Stomach  always  suit  your  Fare. 

The  use  of  vitamine-containing  foods  is  not  forgotten,  and  the 
lines  about  wine  sound  as  strange  in  a  dry  country,  as  would  the 
tinkling  of  icicles  in  tropical  Sahara. 

Mix  Water  with  your  Wine  to  quench  your  Thirst, 

And  never  let  the  last  exceed  the  first. 

Fruits,  Herbs,  and  Sallads,  when  the  Body's  dry, 

The  want  of  Moisture  will  as  well  supply. 

In  these  be  sparing,  for  the  frequent  Use 

May  to  crude  Humours  turn  the  cooling  Juice. 

Can  you  imagine  a  better  account  of  the  abnormal  cravings 
of  pregnant  women  than  Sainte-Marthe  gives?  It  should  be  quoted 
in  every  book  on  obstetrics. 

But  Teeming  Women,  when  Desire  grows  strong, 
Are  apt  for  ev'ry  thing  they  see  to  Long. 
Sand,  Chalk,  and  Dirt,  their  Appetite  provoke, 
The  Hearth's  black  Ashes,  and  the  Chimney's  Smoke. 
Nay,  once  I  saw  a  Pregnant  Wife  devour 
A  living  Chick,  and  lick  its  reeking  Gore: 
Cackling  she  seiz'd  it,  in  the  flut'ring  Brood, 
And  tore  its  Flesh  alive,  and  suck'd  its  Blood; 
Bones,  Feathers,  Garbidge  in  her  Mouth  were  seen, 
And  Putid  Clotts  defil'd  her  Breasts  obscene. 

The  second  book  begins  with  the  birth  of  the  child.  The 
cord  is  cared  for: 

But  lest  too  fast  its  Vital  Spirits  fly, 

And  with  the  loss  of  Blood  the  Infant  Die; 

First  let  the  Navel  with  soft  Wool  be  bound, 

Then  noint  with  Mastick  and  sweet  Mirrh  the  Wound. 


THE  PEDIATRIC  POEMS  507 

And  it  is  dressed,  but  one  must  dissent  from  the  remainder 
of  the  following  quotation : 

Thou,  Nurse,  in  swadling  Bands  the  Babe  enfold, 

And  carefully  defend  its  Limbs  from  Cold: 

If  Winter,  by  the  Chimney  place  thy  Chair, 

If  Summer,  then  admit  the  cooling  Air. 

Good  Cordials  give  it,  such  as  bear  the  Name 

Of  him  whose  Glory  rival'd  Pompeys  Fame; 

Who  war'd  with  Rome,  maintain'd  the  Pontick  Throne, 

Delay'd  her  Empire  long,  and  urg'd  his  own. 

Nor  is  it  ill  to  cheer  its  Heart  with  Wine; 

For  of  all  Cordials,  that's  the  most  divine. 

As  oft  as  you  observe  its  Spirits  fail, 

Breath  on  it  from  your  Mouth  a  Spicy  Gale. 

With  Cinnamon  your  healing  Breath  perfume, 

Or  the  sweet  Odours  of  Arabian  Gum. 

Perhaps  you  may  by  this  its  Strength  restore, 

For  kind's  the  Cure,  and  great  is  Nature's  Pow'r. 

If  this  and  nothing  else,  you  do,  prevail, 

But  more  and  more  its  vital  Vigour  fail; 

You  thence  may  judge  to  sudden  Death  'tis  doom'd, 

And  in  cold  Earth  will  quickly  be  intomb'd. 

The  old  barbaric  custom  of  Germanic  races  is  retold  in  graphic 
fashion.  Of  course,  one  doubts  if  such  a  practice  had  ever  more 
than  a  most  limited  following,  but  as  we  have  seen,  the  human 
mind  brings  forth  some  remarkable  methods. 

Of  these,  so  barb'rous  were  their  Ways,  'tis  said, 

They  snatch'd  the  Infant  from  the  Mother's  Bed: 

And  least  it  shou'd  in  Hardiness  decline, 

Plung'd  it  yet  reeking  in  the  frozen  Rhine. 

Their  Force  on  Nature  was  not  less  extream, 

Then  when  red  Iron's  flung  into  the  Stream. 

They  taught  'em,  from  their  Childhood,  to  defie 

The  Frosts  and  Colds  on  an  inclement  Skie. 

Thus  hard,  like  Beasts,  their  humane  Limbs  they  made 

Nor  were  of  Weather,  nor  of  Toil  afraid. 

Such  sure  as  cou'd  this  horrid  Bath  survive, 

Must  from  Caucausean  Rocks  their  Birth  derive. 

The  further  care  is  outlined  in  great  detail,  only  a  part  of 
which  need  be  quoted. 


508  PEDIATRICS  OF  THE  PAST 

Then  the  kind  Nurse,  with  tender  Fingers,  clears 
His  Mouth  from  Filth,  and  e'en  his  Eyes  and  Ears. 
Be  sure,  with  special  Care,  to  clear  the  Doors 
Of  Life,  and  free  the  Passage  of  the  Pores. 
Its  Limbs  benumb'd,  grow  Supple  by  degrees, 
And  then,  like  Molten  Wax,  will  bend  with  Ease. 
Stroke  'em  but  softly,  make  'em  streight  and  sleek; 
They'll  keep,  when  strong,  the  Form  they  take  when  weak. 

Maternal  nursing  is  insisted  upon,  yet  the  author  realizes 
that  sometimes  a  wet-nurse  must  be  employed;  this  whole  subject 
is  neatly  turned  in  the  following  lines: 

If  Health  and  Strength  permit  thee,  don't  refuse 

The  Child  thy  Nipple;  nor  another's  use: 

If  to  the  Babe  thou  dost  thy  own  deny, 

III,  will  a  venal  Pap  its  Wants  supply; 

III,  will  the  Bus'ness  by  that  Nurse  be  done, 

Who  for  another's  Child  neglects  her  own. 

Yet,  if  thou'rt  sickly,  if  thy  Spirits  fail, 

If  the  Child's  touch'd  with  any  catching  Ail, 

This  Duty,  whether  hated  or  desir'd, 

Ceases,  and  'tis  no  more  of  thee  requir'd. 

Then  not  to  Suckle,  is  not  to  neglect, 

But  chuse  a  Nurse,  and  I'll  thy  Choice  direct. 

A  middle  Age  is  best,  nor  Old  nor  Young, 

Fresh  be  her  Colour,  and  her  Body  strong; 

Active  and  Healthy  let  her  be,  and  Clean; 

In  Flesh,  not  over  Fat,  nor  over  Lean; 

Long  be  her  Neck,  and  broad  her  snowy  Chest; 

Her  Arms  of  full  Extent,  and  Plump  her  Breast. 

Let  on  each  Pap  a  ruddy  Nipple  bud, 

And  the  Twin-Hillocks  strut  with  vary'd  Blood. 

The  Babe's  delighted  with  a  flowing  Feast: 

The  sweetest  and  the  whitest  Milk  is  best. 

If  'tis  of  an  ungrateful  Smell,  be  sure 

Those  Fountains  to  avoid,  for  they're  impure. 

Or  if  it  sticks,  when  by  the  Finger  try'd, 

'Tis  bad;  nor  shou'd  it  thence  too  swiftly  glide. 

She  must  not  with  a  late  Conception  Teem, 

Nor  of  the  marriage  Joy,  forgotten,  dream. 

And  as  the  Birth  should  not  too  long  be  past, 

She  should  not  lately  have  her  Burthen  cast. 


THE  PEDIATRIC  POEMS  509 

The  directions  to  the  nurse  are  interesting.  The  old  finger 
or  nail  test  has,  of  course,  been  noted  in  the  foregoing  quota- 
tion; note  in  the  subjoined,  the  statement  about  the  first  milk. 
This  milk  is,  as  is  well  known,  the  thinnest  and  if  there  is  bacterial 
contamination,  this  part  contains  the  most  germs. 

Milk  always  on  the  Ground  your  Breasts;  the  worst 

Of  all  your  liquid  Store  is  what  comes  first. 

For  as  'tis  far  remov'd  from  Life's  warm  Seat, 

So  smalPs  its  mixture  of  the  living  Heat. 

Fling  off  the  useless  and  corrupted  Juice, 

And  teach  the  Child  the  Nipple's  frequent  use. 

From  the  twin  Fountains  let  the  Nectar  flow, 

Greedy  he'll  suck,  and  to  your  Bosom  grow. 

First  with  weak  Lips  the  swelling  Breast  he'll  pull; 

Help  him,  and  squeeze  it  'till  his  Belly's  full. 

But  let  him  not  be  glutted  with  the  Feast, 

A  medium  in  the  flowing  Meal  is  best. 

Sometimes  deny  the  Nipple,  sometimes  grant; 

But  too  much  wat'ring  drowns  the  sprouting  Plant. 

Check  him  when  he's  too  eager  of  the  Breast, 

And  for  a  while  delay  the  milky  Feast. 

Thus  did  of  old  the  Rbodian  Sportsmen  balk, 

And  Cretan  Hunters  check  the  hungry  Hawk: 

They  shew'd  him  Food,  and  what  they  shew'd  refus'd; 

They  gave,  deny'd,  and  thus  to  feed  'twas  us'd, 

Lest  at  one  swallow  he  the  Meal  might  eat, 

And  gorge  himself  with  the  untasted  Meat. 

To  the  Child's  Age  and  Health  adapt  its  Food, 

For  all  things  mayn't  to  all  alike  be  good. 

If  weak  in  Health,  be  sparing  in  the  Meal; 

If  strong  its  Constitution,  feed  it  well. 

You  must  not  in  the  Month  the  Portion  give, 

As  when  'tis  older;  for  with  less  'twill  thrive. 

Of  interest,  too,  are  the  following  notions  of  the  nursing 
schedule  and  the  time  for  beginning  feeding  in  the  eighth  month. 

The  Hours  for  Suckling  it  I  do  not  fix, 
Nature  in  that  must  guide  the  nursing  Sex. 
When  by  its  Cries  it  calls  you,  do  not  spare 
Your  Labour,  nor  be  loath  your  Breast  to  bare. 
Since  with  the  Breast  he  must  not  long  be  fed, 


5io  PEDIATRICS  OF  THE  PAST 

His  growing  Teeth  prepares  his  Age  for  Bread, 
For  when  eight  Moons  have  run  their  wonted  Race, 
The  fluid  to  the  solid  Meal  gives  place. 
Alternate  be  his  Food,  but  have  regard 
To  his  young  Days;  nor  be  it  strong  nor  hard: 
For  heavy  Meals,  that  don't  with  ease  digest, 
May  raise  a  Tumult  in  his  tender  Breast. 

The  following  extracts  need  no  comment: 

When  the  Child's  Diet  shou'd  be  chang'd, 

What  most  resembles  Milk,  in  Tast  and  Use. 

No  good  from  any  thing  that's  New  expect, 

Unless  you  know  that  Newness  to  Correct. 

As  Physick  out  of  Poison  may  be  had, 

So  good  may  be  the  Mean,  th'  Extream  bad. 

Broth  may  be  oft  and  innocently  us'd, 

And  the  soft  Bread  that's  in  the  Broth  infus'd. 

But  Pap,  the  Infant's  Dish,  I  most  approve; 

This  Nurses  most  commend,  and  Children  love. 

With  Milk  and  Bread  the  sooty  Tin  they  fill, 

Stir  it  together  o'er  the  Fire,  and  boil. 

They  try  it  with  a  touch,  the  Spoon  they  dip, 

Blow  it,  and  put  it  to  his  craving  Lip. 

Sometimes  the  Bread  they  with  a  gentle  Thumb 

Break,  and  in  Broth  or  else  with  Butter  crumb. 

As  he  in  Age  and  Strength  of  Body  grows, 

That  Strength  in  time  the  use  of  Flesh  allows. 

Feed  him,  when  mine'd,  to  ease  the  toothless  Gum, 

Some  Meals  on  Flesh,  and  at  the  Nipple  some; 

His  Hunger  willingly  with  both  supply, 

But  ben't  deceiv'd,  and  do  not  trust  his  Cry; 

For  he's  not  always  hungry  when  he  Squalls, 

And  oft  for  neither  Meat  nor  Drink  he  calls. 

As  when  a  Pin,  which  often  happens,  pricks, 

Or  Gripes  his  little  Entrails  tear,  he  shrieks. 

Be  not  too  fond  of  feeding  him,  but  spare 

The  Spoon,  nor  love  to  lay  your  Bosom  bare. 

Don't  you,  as  Mothers  love,  with  frequent  Food, 

Above  its  strength,  your  Infant's  Stomach  load. 

Thence  puking  Pains  and  other  Ills  arise, 

While  the  crude  Burthen  undigested  lyes. 

And  thus  what  Nature  meant  for  Life's  Support, 

Cuts  off  his  Days,  instead  of  Iengthning,  short. 


THE  PEDIATRIC  POEMS  511 

Observe  due  distances  between  his  Meals, 
Nor  feed  him  when  you  find  his  Belly  swells. 
If  you  see  Blotches  rising  on  his  Skin, 
They  shew  the  Load  tha't  undischrg'd  within. 
Perhaps  e'en  now  he'll  roar;  why,  let  him  roar, 
And  don't  you  feed  him  'till  he  wants  it  more, 
'Till  Nature  has  consum'd  the  present  Store. 
Let  him  his  Lungs,  for  Crying's  useful,  strein, 
'Twill  purge  a  heavy  or  a  watry  Brain. 

Wash  him  a  Nights,  e'er  you  the  Cradle  make, 
He'll  sleep  the  sounder,  and  the  sooner  wake. 
Stir  him,  and  toss  him,  for  an  Infant's  Sloth 
Produces  Rickets,  and  prevents  his  Growth. 
If  to  be  carry 'd,  he,  by  crying,  begs, 
Keep  him,  when  he  can  go,  upon  his  Legs. 
And  Prattle  to  him  sometimes,  sometimes  sing, 
Or  to  his  Ear  the  tingling  Coral  ring. 
Nor  less  to  Dandle  him  and  Dance  forbear, 
Nor  keep  him  in  the  House,  but  give  him  Air. 
When  Western  Winds  with  balmy  Wings  perfume 
The  Fields,  and  Heav'n  invites,  who'd  stay  at  Home? 
Shew  him  the  painted  Skies,  their  rolling  Fires, 
Tell  him  who  made  what  he  so  much  admires: 
Teach  him  betimes  to  know  his  mighty  Pow'r, 
Betimes  their  Maker  and  his  own  Adore. 

The  last  book  deals  with  the  diseases  of  infants. 

To  what  Distempers  Infants  are  expos'd, 

I'll  sing;  and  when  'tis  sung,  my  Song  is  clos'd. 

I'll  tell,  and  to  be  short,  but  hint  the  Chief; 

Of  ranula,  certainly  overestimated  as  a  danger,  though  per- 
haps not  to  Sainte-Marthe,  he  says : 

The  worst  Disease  that  can  a  Child  befal, 
We  Ranula  from  a  Barbarian  call. 
For  in  its  Figure  'tis  exactly  like 
A  Frog,  if  off  its  leaping  Limbs  you  strike, 
Beneath  the  Tongue  a  cank'ring  Tumour  grows, 
Which  oft  with  burning,  worse  than  Fev'rish  glows. 
If  'tis  not  to  be  cur'd,  the  Child  must  dye, 
And  its  Soul  soon  will  from  its  Body  fly. 


5i2  PEDIATRICS  OF  THE  PAST 

Perhaps  he  referred  to  Ludwig's  angina. 

Tonsillitis  is  ascribed  to  the  nurse's  milk  and  she  is  advised 
to  begin  the  cure  by  caring  for  herself. 

The  Signs  of  that  Distemper  are  the  same, 
Which  grievously  the  Infant's  Jaws  enflame, 
And  from  the  Glands  Tonsilae  is  its  Name. 
At  the  Tongue's  Root  these  little  Glands  you  find, 
Where  with  the  Throat  the  Moving  Member's  join'd. 
From  Blood  corrupted  this  Distemper  grows, 
And  to  that  Blood  the  Milk  its  Vices  owes. 


Fever  is  treated  with  lemonade  or  oil  of  violets,  earache 
by  dropping  warm  violet  oil  into  the  ear,  while  milk  and  barley 
flour  poultices  are  to  be  applied  externally.  For  teething  the 
inevitable  hare's  brains,  honey,  or  a  coral  ring  are  advised. 

For  Teeth  the  Stomach  serve,  and  Life  maintain, 

And  none  can  have  the  Tooth,  without  the  Pain. 

The  sufPring  Infant  tells  it  by  his  Cries, 

His  driv'Iing  Mouth  he  with  his  Fingers  plies, 

He  strives  to  help  himself,  but  strives  in  vain, 

The  Nurse's  Help  must  ease  him  of  his  Pain. 

In  a  Hare's  Brain  his  little  Fingers  dip, 

Or  what  Sicilian  Bees  from  Roses  sip. 

The  raging  Gum,  the  Sweets  and  Softness  sooth, 

And  white  amidst  the  Red  appears  the  Tooth: 

As  the  white  Iv'ry  in  red  Coral  shines, 

Which  wrought  with  curious  Art,  the  Workman  joins. 

But  if  the  Pain  encreases,  wash  his  Head 

With  Milk  and  liquid  Sweets  of  Roses  made. 

Warm  be  the  Bath,  and  wrap  his  Infant  Skull, 

When  well  it  has  been  wash'd,  in  downy  Wool. 

Yet  all  your  Labour's  lost,  except  you  find 

His  Load  discharges,  and  he's  Lax  behind. 

His  Body  bound,  with  liquid  Honey  loose; 

What  Thing  was  ever  found  of  greater  Use? 

Cou'd  Heav'n  a  better  Grant,  and  Earth  produce? 

This  give  him  at  his  Mouth,  or  else  convey 

The  Physick  by  a  Pipe  the  other  way: 

But  if  there  wants  of  this  Celestial  Dew, 

Then  Bete  or  the  Marshmalloe  Root  will  do. 


THE  PEDIATRIC  POEMS  513 

For  colic  he  gives  several  suggestions  and  touches  on  the 
subject  of  helminthiasis  after  making  the  query:  "With  Worms 
what  need  the  Muse  defile  her  Strains?"  The  part  about  worms 
is  omitted  here  lest  the  Muse  be  offended. 

And  if  with  racking  Gripes  his  Belly's  rent, 
The  Gnawings  in  his  Bowels  to  prevent, 
Warm  Water,  and  the  Parts  aggriev'd  foment; 
Or  else  anoint  with  Oil  of  Camomile 
His  Belly,  or  with  Oil  of  fragrant  Dill, 
Or  what  old  Olives  o'er  the  Fire  distil. 
For  the  kind  Heat  insinuates  by  degrees, 
And  passes  to  th'  afflicted  Place  with  Ease; 
It  drives  the  Cold  out  of  the  Porous  Skin, 
And  dissipates  the  Winds  that  rage  within. 
The  Causes  and  Effects  of  this  Disease 
It  cures,  and  gives  the  patient  Infant  Ease. 

Verse  is  put  to  strange  uses,  just  as  is  prose.  One  of  the  strang- 
est of  human  documents  is  in  French,  "L'Art  gentile  de  Peter." 
This  would  seem  rather  to  belong  to  the  Teutonic  order  of  humor 
than  to  the  Gallic,  but  Sainte-Marthe  celebrates  in  rhyme  pro- 
lapse of  the  rectum,  certainly  no  mean  task. 

Why  shou'd  I  name  how  the  Posterior  Pipe 
Is  apt  the  Bounds  in  weakly  Babes  to  slip? 
The  Muscles,  moistn'd  when  the  Belly's  loose, 
Their  nat'ral  Duty  to  discharge,  refuse; 
And  out  the  Anus  hangs,  a  grievous  Pain; 
Nor  is  it  easily  got  in  again. 
The  Body  bind,  foment  it  when  'tis  out, 
And  gently  with  thy  Hand  replace  the  Gut. 

A  neat  little  touch,  needed  today  as  much  as  in  the  eight- 
eenth century  is  as  follows : 

Call  the  Physician  to  your  Aid;  advise 

With  him,  and  do  not  think  your  self  too  wise; 

Do  not  to  ev'ry  idle  Tale  attend, 

Nor  on  old  Womens  Recipe's  depend. 

Too  much  the  Iearn'd  into  this  Error  give, 

Are  thus  deceiv'd  themselves,  and  thus  deceive. 


5i4  PEDIATRICS  OF  THE  PAST 

HUGH    DOWNMAN 
[l740- 1 809] 

Hugh  Downman,  born  in  1740  at  Newton  House,  Exeter, 
the  son  of  Hugh,  received  his  early  education  in  the  Exeter 
grammar  school,  entered  Balliol  College,  Oxford,  in  1758, 
was  graduated  b.  a.  1763,  and  was  ordained  in  the  Exeter  Cathe- 
dral the  same  year.  He  then  went  to  Edinburgh  to  study  medicine, 
where  he  boarded  with  the  blind  poet,  Thomas  Blacklock.  The  year 
1769  found  him  in  London  walking  the  hospitals.  After  receiving 
m.  a.  at  Jesus  College,  he  practiced  in  Exeter,  but  after  some 
eight  years,  ill  health  drove  him  into  temporary  retirement.  Some 
twelve  years  later,  he  resumed  practice  and  founded  a  literary 
society.  His  health  again  caused  him  to  give  up  active  duties 
and  he  died  September  23,  1809. 

He  left  the  reputation  of  an  able  physician  but  he  was,  per- 
haps, much  better  known  as  a  man  of  letters.  He  was  a  prolific 
writer.  Best  known  of  his  works  is  the  "Infancy,  or  the  Manage- 
ment of  Children:  a  Didactic  Poem,  in  Six  Books,"  published  in 
three  separate  parts,  1774,  I775  an^  1776,  London.  The  original 
edition  was  a  quarto.  Seven  editions  were  published  during  his 
life.  As  early  as  1768  he  had  published  a  poem  entitled  "The 
Land  of  the  Muses."  Later  he  turned  his  hand  to  play  writing,  but 
with  indifferent  success.  His  plays  were  collected  and  printed  in 
one  volume  in  1792.  These  plays  included  "Lucius  Junius  Brutus," 
"  Belisarius,"  which  lasted  a  few  nights  in  a  theater  in  Exeter, 
and  "Edith,  a  Tragedy,"  which  ran  sixteen  nights.  He  wrote 
numerous  other  poems  which  were  collected  and  reprinted  in 
several  editions.  He  also  helped  translate  Voltaire  for  the 
English  edition  of  1781.  Shortly  before  Downman  died,  some 
anonymous  author  collected  and  published  his  various  poems, 
with  criticisms  of  them. 

The  poem  on  "Infancy"  is  long,  in  six  books,  each  preceded 
by  an  argument.  Some  idea  may  be  gained  by  perusing  the  first 
book. 

ARGUMENT 

The  Invocation  and  Introduction.  Health  is  the  greatest  blessing  of 
mankind. — It  should  be  the  chief  aim  of  parents  to  procure  their  children 
the  enjoyment  of  it. — Nature  and*instinct  therefore  are  to  be  followed. — 
Pernicious  custom  of  giving  children  some  drug  soon  after  they  are  born. 


Hugh  Downman 
[1740- 1 809] 


INFANCY, 


Oft  TRB 


MANAGEMENT  of  CHILDREN  i 


DIDACTIC    POEM, 

In    SIX   BOOKS. 


tt'M'Oi 


THE   SIXTH   EDITION. 


By  HUGH  DOWNMAN,   M.  D. 


EXETER: 
Punted  and  sold  it  TREWMAN  AV9  SON; 

9M.P  AIM  fry  CADELL  AMD  DAVIES,    AND  G.  KEAASLEY,    LONDON; 
AND  J.  BELL  AND  J.  BHADFUTE,    EDINIVEON. 


W,DCCC,1I 


Title  page  of  Hugh  Downman's  poem. 


5i6  PEDIATRICS  OF  THE  PAST 

The  best  remedy,  at  that  time,  is  the  first  milk  of  the  mother. — Various 
reasons  and  motives  for  the  mother's  suckling  her  children. — An  amiable 
duty. — Apostrophe  to  tender  affection. — Directions  how  to  choose  a 
nurse,  if  the  mother  can  not  perform  that  office  herself. — Cities  destruc- 
tive to  infants.  Recommendation  of  the  country. — The  mother  should 
oversee  the  conduct  of  the  nurse. — The  nurse's  usual  manner  of  life 
should  be  altered  as  little  as  possible. — Address  to  Habit. 

A  few  selections  will  give  the  reader  an  idea  of  his  style.  He 
pays  a  tribute  to  Armstrong  as  follows: 

.    .    .   nor  blind  to  worth, 
Tho'  still  upon  the  wave-worn  shore  it  stand 
Of  troublous  life,  by  envious  blasts  assail'd 
Be  thou  ungreeted,  Armstrong,  in  my  verse, 
Thou  parent  of  the  prophylactic  lay! 

He  had  a  proper  lack  of  appreciation  of  the  untrained  and 
little  faith  in  the  wisdom  of  the  ignorant. 

We  write  to  reason :  Hence  ye  doting  train 
Of  midwives  and  of  nurses  ignorant! 
Old  beldames  grey,  in  error  positive, 
And  stiff  in  prejudice,  whose  fatal  care 
Of  death  attends,  or  a  life  worse  than  death. 

One  part  of  the  poem  should  be  printed  for  medical  students; 
the  description  of  how  to  observe  the  sick  child,  how  it  uncon- 
sciously describes  its  symptoms : 

Because  the  child,  with  reason  unendow'd 

And  power  of  speech,  by  words  to  express  his  grief 

Nature  permits  not;  some  believe  the  source 

Of  anguish  and  affections  is  conceal'd 

From  every  eye,  and  deem  assistance  vain. 

Or  to  the  nurse,  or  vaunting  midwife  trust, 

Who  cases  manifold  and  similar 

Have  oft  beheld,  and  never  faiPd  to  cure: 

For  each  her  nostrum  boasts;  if  harmless  this, 

And  trifling,  it  were  well,  did  not  the  wing 

Of  time  speed  fast  the  irrevocable  hour 

Of  wish'd  redress.  But  frequently  the  drug 

They  praise,  the  cordial  drops  are  fraught  with  death, 

Hurrying  convulsions  on  of  direst  kind; 

Or  with  narcotic  venom  strong  embued, 

Plunging  the  patient  in  eternal  sleep. 


THE  PEDIATRIC  POEMS  517 

Yet  nature,  in  thy  child,  tbo'  not  in  words, 

Speaks  plain  to  those  who  in  her  language  vers'd 

Justly  interpret.  Are  the  different  tones 

Of  woe  unfaithful  sounds?  Can  he,  whose  sight 

Hath  traced  the  various  muscles  in  their  course, 

When  irritated  in  the  different  limbs, 

Retracted,  or  extended,  or  supine, 

Fix  no  conclusions  on  the  seat  of  pain? 

Is  it  of  no  avail  to  mark  the  breath, 

How  drawn?  the  face?  the  motions  of  the  eye? 

The  salient  pulse?  the  eruptions  on  the  skin? 

The  skin  itself,  constructed  or  relaxed? 

The  mode  of  sleep?  of  waking?  heat?  or  thirst? 

From  which,  and  numerous  traits  beside  arranged, 

Combined,  abstracted,  and  maturely  sigh'd, 

Judgment  its  practice  forms?  Are  characters 

Like  these  which  ask  the  nice  decyphering  soul, 

Intelligible  to  beldames  old, 

Who  wrapped  in  darkness,  utter  prophesies 

And  lying  oracles,  which  cheat  the  ear, 

Or  followed,  to  destruction  lead  the  way? 

Oh!  may  good  angels,  kindling  in  thy  breast 

The  lamp  of  reason,  guard  thee  from  their  snares! 

Blind  guides  assiduous  to  deceive  the  blind. 

But,  now  with  idle  terrors  do  we  seek 
To  wound  affection,  from  experience  taught 
We  know  what  medicines,  different  in  effect, 
And  opposite,  the  varying  symptoms  claim. 
Antophlogistics  which  the  vital  heat 
Increased,  depress;  and  Cardiacs  which  excite; 
And  Opiate  Sedatives,  in  vulgar  hands 
Pernicious  as  the  deadly  nightshade's  juice, 
And  Drastics,  which  consummate  spell  along, 
And  wise  discretion,  when  the  moment  calls, 
Should  dare  advise. 

Another  fragment  about  the  lymph  nodes  in  infancy  and  we 
shall  finish  with  the  all  but  forgotten  Downman. 

The  wild  delusions  which  the  source  affords, 
With  silent  scorn  or  pity  had  the  muse 
Often  attested.  The  luxuriant  glands, 
In  infants  stiled  of  disproportion^  size, 


5i8  PEDIATRICS  OF  THE  PAST 

And  the  two  copious  fluids,  they  secern, 
Or  tough  and  viscid,  some  alone  condemn. 
As  if  these  glands  by  nature  were  ordain'd 
So  large  without  design,  or  worse,  to  prove 
The  cisterns  of  disease.  Acidity 
Some  only  blame;  and  some  the  sting  severe 
Of  acrimonious  humours.  These  accuse 
The  noisome  worm,  however  hid  from  sight 
Those,  as  exciting  fever,  reprobate 
Nought  but  the  growing  teeth.  Repletion  some. 
While  others  dreadful  fits  survey  within, 
Or  e'en  pretend  to  trace  them  in  the  smile 
Of  downy  sleep.  Nor  women  solely  err. 
The  pedant  has  his  whims;  and  he  the  light 
Fantastic  form,  who  superficial  skims 
The  froth  of  science,  yet  would  fain  appear 
Most  intimate  in  its  profoundest  depths; 
Now  a  phenomenom  beholds,  to  which, 
Like  the  first  man,  intuitively  wise, 
He  cannot  give  a  name.  What  strange  conceits 
Have  not  philosophers  embraced,  intent 
The  principles  of  Galen  to  defend! 
Or  to  deduce  from  chymic  elements 
Recondite  causes!  Or  the  line  supply 
And  mathematic  rule,  to  buildings  raised 
On  mere  imaginary  ground!  Or  search 
The  moon,  then  aspects  of  the  different  stars ! 
While  some,  from  animated  beings,  thick 
Diffused  through  space,  invisibly  minute, 
Have  every  ill  derived,  tormenting  man. 


THE  HERBERDENS 

WILLIAM   THE    FATHER    [17IO-1801] 
WILLIAM   THE    SON    [  1 767- 1 845] 

THE  "Epitome,"  which  is  reprinted  in  its  entirety,  is  one  of 
the  gems  of  the  earlier  pediatric  literature  and  while  it  was 
published  in  1808,  it  really  belongs  to  the  "last"  century 
literature,  even  in  probable  date  of  composition  and  so  is  included 
here  rather  than  in  a  subsequent  volume,  should  the  reception  of 
this  one  warrant  such  a  venture.  It  was  published  by  William 
Heberden,  the  younger,  but  the  information  in  a  large  part  must 
have  been  garnered  by  his  father  so  that  any  sketch  of  the  son 
must  include  the  father. 

Piety  is  not  ordinarily  an  attribute  of  physicians.  Their 
mode  of  life,  their  contact  with  individuals,  their  point  of  view 
incline  them  to  believe  that  a  good  set  of  teeth  is  more  important 
than  the  particular  brand  of  faith  a  man  may  have.  Nay,  if  we 
follow  Oliver  Wendell  Holmes  we  may  think  that  we  can  pick  out 
the  Presbyterians  by  an  examination  of  their  livers.  The  Heber- 
dens  were  both  of  them  pious.  Probably  no  better  examples  of  it 
are  to  be  found  in  the  annals  of  medical  history.  The  son  resembled 
the  father  and  ere  long  gave  up  medicine  to  write  forgotten  tomes 
on  theological  subjects.  Of  the  father  it  was  said:  "He  was  pious 
without  hypocrisy,  virtuous  without  austerity,  and  beneficient 
without  ostentation." 

The  father  was  born  in  17 10,  a  year  before  Cadogan,  and  was 
educated  at  St.  John's  College,  Cambridge.  His  degrees  were 
b.  a.,  1728;  Fellowship,  1730;  m.  a.,  1732;  m.  d.,  1739.  He  was 
a  scholar,  a  deep  student  of  the  classics,  and  like  many  of  the 
English  physicians,  thoroughly  at  home  in  Latin  and  Greek  and 
devoted  to  the  poets. 

He  practiced  in  the  University  ten  years,  read  an  annual 
course  of  lectures  on  materia  medica  and  in  1750  presented  his 

519      , 


520  PEDIATRICS  OF  THE  PAST 

collection  of  specimens  to  his  College.  In  1746  he  became  a 
Fellow  of  the  Royal  College  of  Physicians  and  two  years  later 
he  settled  in  London,  the  ultimate  goal  of  the  English  physician. 
He  was  made  a  Fellow  of  the  Royal  Society  in  1749;  an  honorary 
member  of  the  Royal  Society  of  Medicine  of  Paris  in  1778,  and  in 
1 76 1  he  declined  the  honor  of  becoming  physician  to  Queen 
Charlotte.  A  curious  record  is  made  by  Pettigrew  of  the  account 
which  Heberden  drew  up  of  his  own  life,  to  be  used  by  the  Royal 
Medical  Society  of  Paris.  It  included  the  day,  month  and  year 
of  his  death,  left  blank. 

Naturally  such  a  man  would  be  honored  and  he  was  Goulstonian 
lecturer  in  1749,  Harveian,  in  1750,  and  Crooniam  lecturer  in 
1760.  In  1774  he,  in  company  with  others,  founded  the  Humane 
Society. 

On  one  occasion  he  saw  the  Duke  of  Leeds  in  consultation 
with  Mead;  noting  the  Iatter's  senile  condition  he  vowed  he  would 
retire  at  seventy-eight,  but  he  waited  only  until  he  was  seventy- 
two,  and  in  1782  he  withdrew  to  Windsor  for  the  summer  months. 
In  1796  an  accident  disabled  him  for  the  rest  of  his  life.  He 
died  in  1801.  Two  days  before  his  death  he  quoted  from  some 
Latin  author:  "Death  is  kinder  to  none  than  those  to  whom  it 
comes  uninvoked."  Such  is  a  thumb-nail  sketch  of  one  of  Britain's 
greatest  medical  luminaries. 

He  was  a  very  charitable  man,  but  charity  is  a  common  virtue 
among  physicians.  His  piety  he  backed  up  in  a  practical  way.  A 
Mr.  Markland  did  a  series  of  notes  to  the  "Suppliants''  of 
Euripides.  The  complete  volume  was  issued  in  a  250  copy  edi- 
tion without  the  name  of  editor  or  commentator  and  Heberden 
paid  for  the  whole  thing.  A  better  story,  however,  is  his  experience 
with  a  work  by  Conyers  Middleton  on  the  "Inefficiency  of 
Prayer."  He  bought  the  manuscript  from  the  widow  for  fifty 
pounds  and  burnt  it.  MacMichael  says  he  paid  two  hundred 
pounds. 

Heberden  knew  most  of  the  literary  lights  of  his  day  and  was 
himself  a  man  to  whom  the  term  "a  gentleman  and  a  scholar" 
could  be  correctly  applied.  Both  he  and  his  son  William  wrote 
Latin  of  a  fine  quality,  far  above  the  "dog"  Latin  of  the  average 
medical  publication.  It  was  a  Latin  with  style.  Dr.  Johnson 
called  Heberden  ultimus  Romanorum  (the  last  of  the  Romans); 
while   Soemmering,   who   brought   out   his  works  in  Germany, 


William  Heberden 
[1710-1801] 


THE  HERBERDENS  521 

dubbed  him  medicus  vere  Hippocrates.  Another  proof  of  the  high 
esteem  in  which  he  was  held  lies  in  the  fact  that  his  commen- 
taries were  admitted  into  the  Latin  Medical  Classics  published 
at  Leipsic  by  Friedlander. 

Heberden  made  a  real  impression  on  English  medicine.  He 
was  clear-sighted,  a  good  observer  and  no  coward.  Elsewhere  in 
this  volume,  the  horrendous  vagaries  of  the  various  London  Phar- 
macopeias have  been  noted.  Figuratively  and  literally  speaking, 
the  recommendations  were  a  stench  in  the  nostrils  of  right- 
thinking  physicians  and  Heberden's  satirical  pamphlet 
entitled  "  'Avridripiana,  an  Essay  on  Mithridatum  and  Theriaca" 
did  much  to  purge  these  publications  of  most  of  their  disgusting 
remedies. 

Then,  as  now,  marvelous  stories  of  wonderful  acting  drugs, 
and  of  equally  wonderful  antidotes,  such  as  were  in  vogue.  Nay, 
more,  they  had  been  the  very  means  in  the  not  distant  past  of 
putting  men  to  death:  in  1598,  in  good  Queen  Bess*  time,  two 
men  were  executed  on  the  charge  of  having  poisoned  her  Majesty's 
saddle.  Ben  Johnson,  in  "Every  Man  in  His  Humour"  uses  the 
idea  of  poisoned  clothes;  a  sort  of  nessus  shirt  complex,  much  in 
vogue  in  the  days  of  Catharine  de'  Medici. 

Kitely.  Now,  God  forbid,  O  me,  I  now  remember, 

My  wife  drank  to  me  last  and  changed  the  cup 
And  bade  me  wear  this  cursed  suit  today. 

The  Medical  Transactions  of  the  Royal  College  oj  Physicians 
were  undertaken  at  his  suggestion  and  three  volumes  were  issued 
in  1768,  1772  and  1785.  These  contain  sixteen  papers  by  him. 

He  gave  the  first  real  description  of  chickenpox : 

1 .  The  appearance  for  the  second  to  the  third  day  from  the  eruption 
of  that  vesicle  full  of  serum  upon  the  top  of  this  pock.  2.  The  crust, 
which  covers  the  pocks  on  the  fifth  day;  at  which  time  those  of  the  small- 
pox are  not  at  the  height  of  their  suppuration. 

In  1775,  ne  wrote  on  influenza.  A  fine  piece  of  medical  writ- 
ing is  that  on  the  pulse,  commenting  amongst  other  things  on 
some  of  the  vagaries  of  others.  Heberden  notes  that  Avicenna 
treated  of  the  pulse  musically,  and  that  Hoffmeister  drew  up  in 


522  PEDIATRICS  OF  THE  PAST 

1 76 1  a  musical  scale  of  the  pulse  "thus  reducing  his  patient  to  a 
harpsichord  and  his  profession  to  a  chapter  on  the  contra-bass." 
In  1766  he  published  an  article  on  angina  pectoris,  or  "Asthma 
Heberdenii"  as  it  came  to  be  called,  but  a  layman  had  preceded 
him  in  this,  as  the  Earl  of  Clarendon,  in  his  memoirs,  details 
clearly  the  case  of  his  father  in  1632.  The  following  year  he 
described  night  blindness  and  the  nodules  which  bear  his  name. 
The  description  of  the  latter  in  his  "Commentaries"  is  as  follows: 


DIGITORUM    NODI 

What  are  those  little  hard  knobs,  about  the  size  of  a  small  pea, 
which  are  frequently  seen  upon  the  fingers,  particularly  a  little  below 
the  top,  near  the  joint?  They  have  no  connexion  with  the  gout,  being 
found  in  persons  who  never  had  it;  they  continue  for  life;  and  being 
hardly  ever  attended  with  pain,  or  disposed  to  become  sores,  are  rather 
unsightly,  than  inconvenient,  though  they  must  be  some  little  hindrance 
to  the  free  use  of  the  fingers. 


The  "Commentaries"  were  arranged  in  1782,  both  in  Latin 
and  English,  but  were  not  published  until  a  year  after  his  death, 
when  the  volume  was  put  out  by  his  son  with  the  title  "Com- 
mentarii  de  Morborum  Historia  et  Curatione."  If  you  do  not 
know  this  volume,  look  it  up.  It  is  worth  while. 

One  more  short  quotation  will  give  some  idea  of  the  charm 
of  Heberden's  style. 

Antimony. — Dioscorides  mentions  it  had  a  vogue  in  physic,  but  it 
was  not  of  long  date,  because  it  is  very  dangerous.  In  about  the  twelfth 
age,  Basilius  Valentinus,  a  certain  monk,  published  a  book,  which  was 
entitled,  "Currus  Antimonii  Triumphalis,"  wherein  he  undertakes  to 
affirm,  that  it  was  a  remedy  against  all  sorts  of  diseases.  Three  hundred 
years  after  Paracelsus  brought  it  into  vogue;  but  then  in  the  year  1566, 
the  use  of  it  was  condemned  by  Act  of  Parliament;  and  accordingly,  one 
Besnier,  a  Physician,  transgressing  it,  was  excluded  the  faculty.  In  the 
year  1637,  Antimony  was  again  received  by  public  authority,  among  the 
purging  medicines;  and  in  1650,  the  Act  made  in  1566  was  repealed.  In 
1657,  the  faculty  caused  it  to  be  inserted  in  their  Antidotarium,  printed 
that  year,  herein  following  the  opinion  of  Mathiolus;  and,  on  the  29th 
of  March,  1668,  gave  it  the  sanction  of  prohibition  to  all  others,  unless 


THE  HERBERDENS  523 

by  their  advice.  Among  the  ancients  Antimony  was  used  to  dye  the 
Supercilia,  or  eye-brows,  black;  and  accordingly,  we  read  in  Scripture, 
that  the  wicked  Queen  Jezebel,  in  order  to  charm  the  King,  her  husband, 
painted  her  eyes,  (by  which,  I  suppose,  is  only  meant  the  eyebrows,  with 
Antimony),  and  the  women  who  used  that  practice  were  also  reproved 
by  the  Prophets;  and  from  thence  it  was  that  this  mineral  got  the  name 
of  fjiovaiK€t,op,  and  some  Greek  author  mentions  it  thus,  nthaivav  o-iju/uj> 
8niAaToy<pa<t>ov;  because  it  seems  to  dilate  the  eyes  and  make  them  appear 
fuller.  It  acquired  the  name  of  antimony  in  the  opinion  of  some  from  the 
aforesaid  Valentine,  who,  in  his  search  after  the  Philosopher's  stone,  was 
wont  to  make  much  use  of  it  for  the  more  ready  fluxing  of  his  metals; 
and  throwing  a  parcel  of  it  to  some  swine,  he  observed  that  they  were 
violently  purged  by  it  after  they  had  eaten  it,  but  afterwards  grew  the 
fatter  upon  it,  which  made  him  harbour  the  opinion,  that  the  same  sort 
cathartick  exhibited  to  those  of  his  own  fraternity,  might  do  them 
much  service;  but  his  experiment  succeeded  so  ill,  that  everyone  who 
took  of  it  died.  This,  therefore,  was  the  reason  it  was  called  Antimony, 
as  being  destructive  to  the  Monks. 

The  elder  Heberden  has  received  his  due  of  biographical 
notice;  his  life  was  written  by  A.  C.  BuIIer  and  he  is  generously 
mentioned  in  "The  Lives  of  the  British  Physicians,"  Munk's 
"Roll  of  the  College  of  Physicians"  and  MacMichael's  "Gold 
Headed  Cane." 

The  younger  Heberden  was  born  in  1767  and  lived  well  into 
the  middle  of  the  next  century,  dying  in  1845.  He  was  a  brilliant 
scholar,  much  like  his  father  in  many  ways.  He  made  a  name  and 
a  place  for  himself  as  is  evidenced  by  his  membership  in  the  Royal 
Society,  that  he  was  Harveian  lecturer  in  1809,  an<^  physician 
to  King  George  in.  He  edited  his  father's  writings  and  wrote  the 
"Epitome,"  but  certainly  it  was  from  notes  made  by  his  father 
or  from  information  gleaned  by  intimate  association  with  that 
master  clinician.  Later  in  life  the  younger  Heberden  retired  to 
devote  his  time  to  rearing  his  family  of  boys,  to  translating 
from  the  Greek  and  Latin  and  to  writing,  chiefly  theological 
articles. 

The  "Epitome  Morborum  Puerilium"  appeared  in  London,  in 
1804.  In  the  following  year  there  was  issued  a  translation  in 
English  with  additional  notes  and  observations,  by  J.  Smith. 
In  1807  Heberden  published  his  own  translation  which  is  as 
follows : 


MORBORUM   PUERILIUM 


EPITOME 


AUCTORE 

GULIELMO  HEBERDEN 

REGI  REGIN^QUE   BRITANNIARUM 
MEDICO  EXTRAORDINARY. 


LONDINI: 

TVPI5  S.  HAMILTON.  SHOE-LANE,  ELEBTSTHKET, 

VENEUNT  APUD  T.  PAYNE;  MEWS-CATE. 
1804. 


Title  page  of  Heberden's  "Epitome.' 


THE  HERBERDENS  525 

AN 

EPITOME 

OF 

THE  DISEASES 

Incident  To 

CHILDREN. 

BY 

WILLIAM  HEBERDEN,  M.D.F.R.S. 

Physician  Extraordinary  to  the  King, 

and  Physician  to  the  Queen. 

London: 

PRINTED  FOR  T.  PAYNE,  Pall  Mall, 

By  Richard  Taylor  and  Co.,  Shoe  lane. 

1807. 

PREFACE 

The  following  Translation  of  my  Epitome  Morborum  Puerilium  has 
been  made  at  the  request  of  several  of  my  friends,  who  persuaded 
me  that  it  would  be  acceptable  to  the  public.  And  it  is  proper  to  notice, 
which  I  do  with  some  reluctance,  that  I  have  been  the  more  ready  to 
comply  with  their  wishes,  in  consequence  of  a  very  different  translation 
having  already  appeared  by  another  hand,  in  which  the  sense  of  the 
original  has  been  in  many  instances  imperfectly  rendered,  and  in  some 
totally  misrepresented. 

The  reader  must  not  expect  any  thing  new  or  uncommon  on  such 
a  subject.  It  has  been  my  endeavor  to  illustrate  it  rather  by  the  rejection 
of  what  is  futile  or  impertinent,  than  by  a  solicitous  inquiry  for  new 
matter,  or  by  any  additions  of  my  own.  Most,  if  not  all  the  diseases 
which  are  here  noticed,  have  been  described  more  at  length  by  other 
authors.  Yet  I  have  thought  it  might  not  be  without  its  use,  to  bring 
the  whole  into  one  view,  unencumbered,  as  much  as  may  be,  by  the 
unscientific  or  absurd  observations  of  illiterate  and  ignorant  people, 
who  have  at  all  times  been  apt  to  suppose  themselves  qualified  to  under- 
take this  branch  of  medicine. 

The  only  deviation  of  any  consequence  from  the  original  Latin 
edition,  is  by  the  insertion  of  Chapter  50,  on  the  subject  of  the  purple 
spots,  which  sometimes  appear  on  the  skin. 


526  PEDIATRICS  OF  THE  PAST 

EPITOME 

Of 

THE  DISEASES 

INCIDENT  TO  CHILDREN 

CHAPTER  i 

ON  THE  DIET  AND  MANAGEMENT  OF  CHILDREN 

It  is  always  desirable,  as  far  as  we  are  able,  to  prevent  diseases  rather 
than  to  cure  them;  to  obviate  their  causes  rather  than  to  remove  their 
effects.  And  this  is  particularly  the  case  with  regard  to  children.  We 
see  other  people  broken  down  with  luxury  and  intemperance,  worn  with 
care,  or  enervated  by  indolence;  whence  they  become  at  once  more 
liable  to  sickness,  and  are  less  easily  restored.  But  the  treatment  of 
children  is  much  more  simple. 

They  never  supt  in  solemn  state, 


Nor  undigested  feasts  did  urge  their  fate, 
Nor  day  to  night  luxuriously  did  join, 
Nor  surfeited  the  rich  Campanian  wine. 

dryden,  Georg.  3. 

But  if  the  frail  and  helpless  condition  of  infants  demand  a  nice 
attention;  if  man  be  ushered  into  the  world  full  of  infirmities  and  wants; 
yet  are  we  all  born  with  a  certain  spring  of  vitality,  a  self-restoring  power, 
which  though  sometimes  disordered  and  oppressed,  does  neither  require, 
nor  bear,  the  administration  of  many  remedies.  Let  then  art  take  example 
from  nature,  and  follow  in  her  steps.  Let  all  tight  bandages  be  removed; 
let  all  superfluous  food  be  withheld;  that  the  play  and  growth  of  the 
limbs  be  unrestrained;  and  that  the  stomach  may  not  be  overloaded, 
nor  the  digestion  impeded.  What  distortion  of  the  limbs,  what  bad  shapes 
have  we  to  deplore  from  the  former  of  these  causes!  On  the  other  hand, 
what  multiplied  evils  arise  from  indigestion!  Sometimes  there  occurs 
vomiting,  sometimes  distension,  sometimes  griping,  and  very  frequently 
acidities.  It  is  doubtful  whether  we  may  not  often  attribute  to  the  same 
origin  likewise,  the  thrush,  worms,  wakefulness,  pining,  weakness, 
eruptions,  and  convulsions,  to  all  of  which  children  are  especially  subject. 
But  when  we  observe  that  milk  is  the  sustenance  naturally  provided  for 
infants  in  the  breast  of  their  mother;  why  should  not  the  food  which  is 
artificially  prepared,  be  made  to  bear  some  near  resemblance  to 
this,  which  we  are  sure  must  be  proper  for  them?  For  what  can  anyone 
hope  to  effect  by  the  most  elaborate  combination  of  drugs,  while 
every  day  is  furnishing  fresh  matter  for  disease?  In  fact,  I  am  persuaded 
the  health  of  children  may  best  be  consulted,  not  by  the  daily  invention 


i 


William  Heberdcn,  the  Younger 
[1767-1854] 


THE  HERBERDENS  527 

of  new  remedies;  but  by  a  careful  management,  and  prudent  regulation 
of  their  diet,  so  as  to  preclude  the  most  usual  sources  of  their  disorders. 

During  the  first  months  of  a  child's  life,  the  milk  of  his  mother 
is  unquestionably  preferable  to  every  other  kind  of  nourishment.  As* 
however,  it  is  usually  more  convenient  to  bring  up  a  child  partly  by 
hand,  as  it  is  called,  at  the  same  time  that  he  sucks;  we  should  be  careful 
so  to  regulate  his  diet,  both  with  regard  to  quantity  and  quality,  that  the 
stomach  may  neither  be  oppressed  with  excess,  nor  the  bowels  disordered 
with  what  is  improper.  But  as  Providence  has  made  human  milk  partaking 
both  of  an  animal  and  vegetable  nature;  so  ought  the  food  prepared  by 
art  to  be  thin,  and  liquid,  and  made  up  of  both  kinds.  And  for  fear  there 
should  be  any  thing,  which  by  constant  repetition  may  be  found  to 
disagree,  it  will  be  right  frequently  to  introduce  some  little  change. 
Neither  must  we  conclude  that  whenever  a  child  cries,  he  is  therefore 
hungry;  or  that  as  often  his  sleep  is  interrupted,  he  should  be  crammed 
with  children's  victuals,  or  pap,  usually  consisting  of  bread  and  water. 
Rather  let  us  endeavor  gradually  to  bring  forward  his  strength  and  facul- 
ties, by  tossing  in  the  arms,  and  such  little  exercise  as  at  that  tender  age 
he  is  capable  of;  and  at  seasonable  intervals  let  proper  food  be  offered. 
For  this  purpose,  horns,  or  what  is  more  elegant,  glass  bottles  perforated 
and  covered  with  parchment,  and  other  contrivances,  have  been 
invented,  which,  while  they  give  occasion  to  some  little  exertion  in  suck- 
ing, in  imitation  of  what  we  see  in  nature,  are  attended  with  this  advan- 
tage, that  a  child  is  not  so  easily  surfeited,  or  induced  to  take  more  than 
he  really  wants.  The  practice  is  best,  which  allows  of  children  being  fed 
frequently  in  the  day,  and  by  little  at  a  time. 

At  first  it  will  be  sufficient  to  give  them  asses  milk;  or  milk  mixed  with 
gruel,  or  with  barley  water,  or  with  thin  panada,  or  rice  water.  These 
again  may  occasionally  be  changed  for  beef  tea,  or  any  plain  broth,  with 
a  little  bread,  biscuit,  or  barley.  AH  which  should  be  passed  through  a 
lawn  sieve,  to  insure  their  being  thin  and  smooth.  At  the  end  of  six 
months  this  diet  may  be  made  a  little  stronger,  and  any  light  pudding 
may  likewise  be  allowed.  Solid  animal  food  is  not  to  be  recommended 
before  the  eighth  or  ninth  month.  Though  instances  are  not  wanting 
of  children  who  have  been  brought  up  from  the  beginning  with  chicken, 
or  other  meat  panada,  without  suffering  from  it  any  apparent  ill  effects. 

Some  substances  are  more  suited  to  a  relaxed,  others  to  a  costive 
habit  of  body.  For  the  first,  cows  milk,  rice,  and  flour  are  proper;  also 
thin  hartshorn  or  isinglas  jelly.  For  the  latter,  whey,  gruel,  puddings 
with  currants,  baked  apples,  or  other  fruit. 

Children  may  with  propriety  be  kept  at  the  breast  a  whole  year. 
They  ought  not  to  be  taken  from  it  sooner  than  the  end  of  four  months. 
Some  allowances  must  however  be  made  for  the  health  of  the  mother, 


528  PEDIATRICS  OF  THE  PAST 

and  for  the  strength  of  the  child;  for  some  will  bear  to  be  weaned  much 
earlier  than  others. 

The  best  drink  for  children  is  milk  and  water,  barley  water,  or  plain 
water.  At  the  end  of  a  twelve-month,  or  sooner,  they  may  be  allowed 
small  beer. 

A  nursery  ought  to  be  a  light,  airy,  and  roomy  chamber,  where 
everything  is  as  clean  and  sweet  as  possible. 

A  child  should  be  amused  and  kept  awake  in  the  day  time,  and  should 
be  habituated  to  sleep  through  the  night. 

He  should  be  frequently  exercised  proportionally  to  his  strength, 
which  will  be  at  once  wholesome  and  pleasant  to  him. 

His  clothes  should  be  loose,  and  should  often  be  changed,  especially 
when  they  happen  to  be  wet.  And  when  he  is  undressed,  his  body  should 
be  gently  rubbed  with  the  hand. 


CHAPTER  2 

OF  EMETICS 

Vomiting  may  be  excited  in  children  by  giving  them  from  three  to 
six  grains  of  ipecacuanha  root  in  powder;  or  from  fifteen  to  forty  drops, 
or  more,  of  ipecacuanha  wine;  or  by  the  same  quantity  of  antimonial 
wine.  Also  by  dissolving  two  grains  of  tartarised  antimony  in  four  ounces 
of  distilled  water,  and  giving  two  drams  of  the  solution  every  quarter 
of  an  hour,  till  it  produce  its  effect.  Another  medicine  of  the  same  kind 
is  prepared  by  mixing  together  two  grains  of  tartarised  antimony  and 
half  a  dram  of  oyster-shell  powder,  of  which  two  grains,  or  more,  may  be 
taken  at  a  time.  Besides  these  remedies,  some  irritate  the  throat  with 
a  feather. 

CHAPTER  3 
OF  PURGATIVES 

In  the  first  months  of  a  child's  life  may  be  given  a  dram  of  castor 
oil;  or,  instead  of  this,  three  grains  of  rhubarb,  the  effect  of  which  will 
be  quickened  by  the  addition  of  one  third  part  of  jalap.  Sometimes  also  a 
clyster  is  useful,  consisting  of  four  or  five  ounces  of  thin  gruel. 

But  as  all  medicines  are  odious  to  children,  it  is  desirable  to  select, 
for  those  who  are  a  little  older,  such  as  are  comprised  in  the  smallest 
bulk,  and  are  of  the  least  offensive  taste.  Of  this  kind  are  four  grains  of 
jalap  with  ten  grains  of  sugar;  or  four  grains  of  jalap  and  one  grain  of 
calomel;  or  eight  grains  of  the  pulvis  scammonii  cum  calomelane.  There 
are  some  things  likewise  which  are  not  unpleasant,  as  the  electuary  of 


THE  HERBERDENS 


529 


senna,  or  a  decoction  of  prunes  and  senna;  (The  decoction  of  prunes  and 
senna  is  prepared  from  half  a  pound  of  French  prunes,  and  half  an  ounce 
of  senna  leaves,  boiled  down  from  a  pint  of  water  to  half  a  pint;  the  senna, 
having  been  tied  up  in  a  linen  bag,  is  then  taken  out),  of  the  former,  a 
dram  is  a  moderate  dose;  of  the  latter,  an  ounce  and  half  with  three  or 
four  of  the  prunes. 

Other  remedies  of  the  same  class  are,  six  drams  of  the  infusion  of  senna 
with  two  drams  of  tincture  of  senna;  or  an  ounce  of  the  infusion  of  senna 
with  eight  grains  of  rhubarb;  also  three  drams  of  Rochelle  salt;  or  half 
an  ounce  of  manna,  with  or  without  the  addition  of  two  drams  of  some 
purging  salt;  or  a  scruple  of  magnesia  with  five  or  six  grains  of  powdered 
jalap.  (As  purgative  medicines  constitute  so  important  a  part  of  the 
cure  in  most  disorders  of  childhood,  I  have  thought  it  might  be  useful  to 
exhibit  more  accurately,  in  the  following  table,  the  actual  effects  of  some 
of  these,  in  a  variety  of  cases,  which  I  noted  down.  The  perpendicular 
lines  distinguish  the  ages  of  the  children;  the  figures  express  the  number 
of  times  that  each  medicine  operated.) 


Ages  of  the  children 


First 

Second 

From 

From 

From 

From 

From 

From 

6  mon. 

6  mon. 

1  to  2 

2  to  3 

3  to  4 

4  to  S 

S  to  6 

6  to  8 

From 
8  to  10 


Olei  Ricini  3  j 

Rhei,  gr.  iij.  Jalap,  gr.  j.. 

Jalap,  gr.  iv 

Jalap,  gr.  iv.  Calomel  gr. 

j 

Rhei  gr.  vj.  P.  Scam.  c. 

Cal.  gr.  iv 

Pulv.  Scam,  cum  Calom. 

3ss 

Rhei  gr.  viij.  Calom.  gr. 

j 

Rhei  gr.  x 

Natri  Tartarisati,  3  ij . .  . 
Natri  Tartarisati,  3  iij . . . 

Natri  Vitriolati,  3  iij 

Magnesiae  Vitriolatae,  3 

iij 

Mannae  Kali  Tart.  a.  3  ij . 
Inf.  Sennae  3  vj.  Tr.  Sen. 

3  ij 

Mannae  5  j 

Magnes.  9  ss.  Jalap,  gr. 

vj 

Dec.  Prun.  c.  Senna  5  iss. 
Electuarii  Sennae  3  ss. . . . 
Pulv.  Sennae  comp.  3  ss. . 
Infus.  sen   5  j.  Rhei  gr. 

viij 


o,  i,  2 
3 


2,  1 

3,  2 


3.  1.  1.4 


2,   2,    I 

3 


I,  I 
3 


2 
3,  2 


I.  I 
3.  I 


2,  2 
2,  3 
O,  I 
2,  3 


2 

2,  3.  2 


2 
2,   I 


'2,3,  2 


3 

4.  1 


o 
5,  3 


3.3 


53o  PEDIATRICS  OF  THE  PAST 

CHAPTER  4 

OF  ASTRINGENTS 

It  is  generally  hazardous  to  stop  a  looseness  of  the  bowels  in  children, 
without  previously  administering  some  gentle  purgative.  Then  six  or 
seven  grains  of  prepared  oyster  shells,  with  two  grains  of  cinnamon,  or 
nutmeg,  are  useful;  or  a  medicine  containing  an  ounce  and  a  half  of  the 
chalk  mixture,  one  scruple  of  the  confectio  aromatica,  and  two  drops  of 
tincture  of  opium;  or  two  ounces  of  water,  half  a  dram  of  the  extract  of 
logwood,  and  two  drops  of  tincture  of  opium ;  of  either  of  these  may  be 
taken  two  teaspoonfuls  three  or  four  times  a  day.  Another  medicine 
of  the  same  kind  is  prepared  from  balaustins,  red  roses,  pomegranate 
rind,  and  cinnamon,  of  each  a  dram,  which  are  to  be  boiled  in  a  pint 
of  water  and  half  a  pint  of  milk  till  the  fluid  is  reduced  to  one  half,  then 
half  an  ounce  of  sugar  being  added,  it  forms  not  an  unpleasant  liquor, 
which  may  be  drunk  by  little  at  a  time.  Also  five  or  ten  grains  of  the 
pulvis  cretae  compositus  may  be  given  three  times  a  day;  or  five  grains 
of  powdered  catechu  in  a  little  conserve  of  roses;  or  ten  grains  of  the 
extract  of  logwood  in  a  spoonful  of  milk.  Some  give  two  drops  of  ipeca- 
cuanha wine  every  six  hours.  Lastly,  a  clyster  may  be  thrown  up, 
consisting  of  a  few  ounces  of  fat  broth ;  or  two  ounces  of  starch  mucilage 
with  six  drops  of  tincture  of  opium. 

CHAPTER  5 

ON  THE  SIGNS  OF  INDISPOSITION  IN  CHILDREN 

As  young  children  are  either  not  at  all,  or  very  imperfectly  able 
to  describe  their  own  feelings,  it  becomes  necessary  to  point  out  by  what 
marks  their  disorders  may  principally  be  known.  These  are,  wakefulness; 
restlessness;  crying;  or,  on  the  other  hand,  a  sullen  heaviness;  retching, 
or  vomiting;  loose,  green,  or  slimy  stools;  loathing  of  their  food;  a  dry, 
or  foul  tongue;  convulsions;  retraction  of  the  legs;  emaciation,  or  relaxa- 
tion; a  dry  and  hot  skin;  eruptions;  hiccup;  sudden  startings  from  sleep; 
screaming;  hardness  and  distension  of  the  belly;  difficulty  of  breathing; 
strong  pulsation  of  the  arteries  in  the  neck. 

CHAPTER  6 

OF  THOSE  WHO  ARE  BORN  APPARENTLY  LIFELESS 

Children  who  are  born  without  signs  of  life,  may  yet  sometimes  be 
saved  by  timely  attention.  For  this  purpose  it  is  useful  to  throw  up  injec- 
tions of  any  warm  liquid;  to  rub  the  body  either  with  the  hand  alone, 


THE  HERBERDENS  531 

or  with  a  little  brandy;  and  lastly,  to  inflate  the  lungs,  by  blowing  into 
the  mouth. 

The  same  remedies  will  be  proper  in  cases  of  suspended  animation, 
from  whatever  cause  it  may  arise. 

CHAPTER  7 

ON  THE  BLACK  COLOUR  OF  INFANTS 

It  sometimes  happens,  that  immediately  after  the  birth  the  face  and 
neck  put  on  a  black  or  livid  appearance,  the  lips  become  purple,  and  the 
breathing  short.  These  symptoms,  if  they  do  not  very  soon  go  off, 
usually  terminate  in  a  speedy  death.  They  are  to  be  attributed  either 
to  some  mal-formation  of  the  heart;  or  to  the  vessels  having  imperfectly 
undergone  those  changes  which  are  necessary  for  all  animals  who  breathe 
the  common  air. 

CHAPTER  8 

OF  THE  MECONIUM 

During  the  two  or  three  first  days  of  a  child's  life,  the  bowels  dis- 
charge a  dark-coloured  viscid  matter,  which  had  been  lodged  in  the  large 
intestines,  and  has  obtained  the  name  of  meconium.  It  is  prejudicial 
for  this  to  be  retained  in  the  body;  and  in  order  to  promote  its  expulsion, 
the  first  milk  of  all  animals  seems  to  be  endued  with  some  purgative 
quality.  The  same  end  may  be  obtained  by  medicines.  Therefore,  in 
two  hours  after  the  birth,  if  nothing  is  discharged,  it  will  be  right  to  give 
a  dram  of  castor  oil,  or  three  or  four  grains  of  rhubarb.  Some  give  at 
intervals  a  tea-spoonful  of  a  mixture  containing  equal  parts  of  oil  of 
almonds  and  of  syrup;  or  a  dram  of  a  medicine  composed  of  half  an  ounce 
of  manna  and  two  ounces  of  wrater.  Sometimes  stronger  remedies  are 
necessary,  and  are  born  without  inconvenience;  such  as,  two  drams  of 
infusion  of  senna;  or  three  grains  of  jalap.  Something  of  this  kind  must 
be  given,  and  repeated  till  the  bowels  are  effectually  emptied.  It  is  often 
of  use  to  assist  them  by  throwing  up  six  ounces  of  milk  and  water,  or 
thin  gruel,  in  the  form  of  a  clyster. 

CHAPTER  9 

OF  THE  JAUNDICE 

The  jaundice  is  a  common  disorder  among  infants,  and  is  known  by 
the  yellow  color  which  attends  it.  It  is  for  the  most  part  easily  removed, 
by  giving  twice  or  thrice  in  a  week  as  much  rhubarb  as  will  gently  move 


532  PEDIATRICS  OF  THE  PAST 

the  body.  Sometimes  a  vomit  is  useful;  for  which  purpose  fifteen  drops 
of  antimonial  wine,  or  three  grains  of  powdered  ipecacuanha  root,  will 
generally  be  sufficient.  Lastly,  five  grains  of  camomile  flowers  and  two 
grains  of  rhubarb,  or  other  medicines  of  a  similar  kind,  may  be  taken  with 
advantage  once  or  twice  in  the  day  for  a  few  days. 

CHAPTER  10 
OF  THE  THRUSH 

The  thrush  consists  of  small  white  ulcers,  which  arise  on  the  tongue  and 
inside  of  the  cheeks,  and  sometimes  spread  rapidly,  till  the  whole  mouth 
is  lined  as  it  were  with  a  membrane.  At  the  same  time  the  fundament 
often  becomes  red,  owing,  as  it  should  seem,  to  the  sharp  humours,  which 
is  carried  off  this  way.  There  is  a  worse  form  of  the  disease,  in  which  the 
color  is  altered  from  a  white  to  a  more  livid  hue.  Where  it  is  mild,  and 
after  a  few  days  does  not  increase,  it  often  indeed  continues  a  good  while, 
but  is  free  from  danger.  It  is  however  a  troublesome  circumstance,  that 
the  nipples  of  the  nurse  are  often  painfully  affected  from  this  cause.  There 
is  seldom  any  fever  attending  it. 

Among  the  French,  and  especially  in  their  public  hospitals,  the  thrush 
seems  to  be  a  more  frequent,  and  a  much  severer  disease,  than  in 
England. 

At  first  it  is  proper  to  give  so  much  rhubarb  or  magnesia,  as  will 
gently  open  the  body;  afterwards  some  prepared  chalk,  or  oyster-shells, 
and  with  these  a  few  grains  of  camomile  flowers.  Some  also  make  a  change 
in  the  diet  of  the  nurse.  The  food  of  the  child  itself  ought  at  least  to  be 
carefully  regulated. 

The  remedies  adapted  to  the  ulcers  themselves  are,  eight  parts  of 
honey  with  one  of  borax;  or  eight  parts  of  the  conserve  of  roses  with  one 
part  of  alum;  or  the  mel  acetatum;  or  honey  of  roses,  either  by  itself,  or 
to  every  ounce  of  which  are  added  ten  drops  of  the  diluted  vitriolic  acid; 
lastly,  the  mucilage  of  quince  seeds. 

CHAPTER  ii 

OF  THE  HICCUP 

It  is  probable  that  the  hiccup  of  children  may  often  arise  from  some 
acidity,  or  heat  of  the  stomach;  in  which  case,  a  powder  composed  of 
half  a  scruple  of  prepared  chalk  and  three  grains  of  rhubarb  will  be  bene- 
ficial. But  if  it  should  appear  to  be  occasioned  by  nervous  irritation,  then 
it  will  be  proper  to  give  a  few  drops  of  the  spiritus  ammoniae  compositus, 
or  of  the  tinctura  opii  campborata.  Sometimes  also  a  little  vinegar  taken 


THE  HERBERDENS  533 

by  itself  has  proved  an  effectual  remedy.  For  the  same  complaint  it  is 
often  useful  to  rub  the  stomach  with  the  soap  liniment,  either  alone,  or 
with  the  addition  of  a  fourth  part  of  laudanum;  or  to  cover  it  with  a 
blister  plaster. 

CHAPTER  12 
OF  ACIDITY  AND  INDIGESTION 

From  indigestion  and  acidity  of  the  stomach,  children  are  subject  to 
continual  crying  and  restlessness;  they  have  also  sour  eructations,  vomit- 
ings, hiccups,  and  green  stools,  and  their  legs  are  forcibly  drawn  up 
towards  the  body.  There  is  reason  to  think  that  these  disorders  are  often 
occasioned  either  by  too  much,  or  by  improper  food. 

The  first  thing  to  be  done  is  to  clear  the  bowels;  for  which  purpose 
rhubarb  is  particularly  useful.  Afterwards,  a  powder  consisting  of  seven 
grains  of  prepared  oyster-shells,  or  magnesia,  and  three  grains  of  camo- 
mile flowers,  or  colomba  root,  should  be  given  twice  a  day;  or  ten  drops 
of  the  aqua  kali  may  be  swallowed  in  a  bitter  draught.  These  medicines, 
and  others  of  a  similar  kind,  will  have  some  effect  on  the  disorders  of  the 
stomach.  But  as  they  seem  frequently  to  originate  in  some  error  of  the 
diet,  the  proper  regulation  of  this  must  form  a  principal  part  of  their 
cure.  Sometimes  it  is  of  use  to  diminish  the  quantity  of  the  child's  nourish- 
ment; sometimes,  to  increase  the  proportion  of  animal  food,  and  to 
withdraw  something  from  his  bread,  or  other  farinaceous  substances. 
But  the  same  mode  will  not  equally  suit  all  cases.  We  ought  diligently 
to  investigate  wherein  the  mischief  consists  in  each  particular  instance, 
that  we  may  be  able  to  supply  what  is  wanting,  either  owing  to  the 
peculiarity  of  the  habit,  or  to  the  nature  of  the  place,  or  to  mismanage- 
ment. Together  with  other  remedies,  exercise,  and  frictions  of  the  body 
should  not  be  omitted. 

CHAPTER  13 

OF  WIND  ON  THE  STOMACH 

Nurses,  who  have  the  care  of  young  children,  talk  much  about  wind. 
To  this  cause  their  crying,  hiccups,  sleeplessness,  and  vomiting  are 
indiscriminately  attributed.  This  however  would  deserve  little  notice, 
were  it  not  customary  to  apply  to  a  complaint  in  itself  almost  nugatory, 
remedies  which  are  pregnant  with  danger.  For  it  is  to  be  apprehended 
that  strong  peppermint  water,  or  spirits,  which  are  sometimes  given  on 
this  account  even  to  very  young  children,  may  sooner  put  an  end  to 
the  patient,  than  to  the  disease.  Yet  I  would  not  have  this  so  under- 
stood, as  if  I  imagined  that  children  never  suffered  from  wind  on  the 


534  PEDIATRICS  OF  THE  PAST 

stomach;  or,  if  they  did,  that  they  needed  no  relief.  It  may  arise  in  many 
from  a  bad  system  fo  diet;  sometimes  from  other  causes;  for  the  digestion 
of  infants  is  weak,  and  easily  disordered.  The  first  attention  therefore 
is  necessary  to  see  that  the  patient  take  no  more  nourishment  than  he 
is  able  to  digest;  but  that  he  rather  have  a  little  and  often,  than  too 
much  at  once.  Then  again,  the  kind  of  food  ought  to  be  light,  or  should 
in  some  manner  be  varied.  Besides,  a  few  grains  of  some  bitter  and 
aromatic  powder  are  frequently  serviceable,  taken  once  or  twice  a  day, 
and  at  the  same  time  as  much  rhubarb  as  will  keep  the  body  open. 

CHAPTER  14 
OF  WAKEFULNESS 

On  account  of  wakefulness,  it  is  sometimes  expedient  gently  to  purge 
the  bowels.  But  above  all  things  it  is  useful  to  let  a  child  have  frequent 
exercise  in  the  day  time,  and  to  take  him  into  the  open  air. 

CHAPTER  15 
OF  WORMS 

Different  kinds  of  worms  are  found  in  the  human  body.  In  some 
countries  they  are  very  common,  in  others  less  so:  and  it  may  happen 
that  certain  conditions  of  the  atmosphere  may  be  more  favourable  to 
their  production.  The  largest  species  is  called  the  tape  worm,  from  its 
resemblance  to  a  piece  of  tape.  It  consists  of  a  chain  or  shorter  worms, 
each  individual  of  which  approaches  in  form  to  a  gourd  seed,  and  from 
thence  has  sometimes  been  named.  They  are  more  frequent  in  Switzer- 
land, and  in  Holland,  than  in  this  country.  Another  sort  is  generally 
known  by  the  name  of  the  round  worm,  and  resembles  the  common  earth 
worms.  The  smallest  of  all  are  the  ascarides,  or  thread  worms,  like  little 
pieces  of  thread. 

Each  variety  is  attended  with  nearly  the  same  symptoms.  These 
are,  a  strong  breath;  an  itching  of  the  nose,  and  fundament,  which 
increases  toward  night;  sometimes  an  excessive  appetite,  sometimes 
none  at  all;  pains  of  the  head,  and  stomach;  griping,  and  hardness  of  the 
belly;  vomiting;  slimy  stools;  fever;  thirst;  giddiness;  grinding  of  the 
teeth;  disturbed  sleep;  cough;  and  convulsions. 

But  though  all  these  signs  are  usual  in  cases  of  worms,  yet  they  are 
sometimes  met  with  where  there  are  no  worms;  and  at  other  times  worms 
are  voided  without  any  previous  notice.  So  that  we  may  indeed  form  a 
reasonable  conjecture  of  their  existence;  but  we  cannot  be  certain,  till 
they  have  been  observed  in  the  stools. 


THE  HERBERDENS  535 

It  is  useful  to  purge  the  body  with  the  infusion  of  senna,  or  with 
rhubarb,  or  jalap,  to  which  most  join  a  small  proportion  of  calomel. 
These  must  be  repeated  at  moderate  intervals,  as  the  strength  will  bear. 
Sometimes  injections  are  of  service,  especially  when  the  worms  are  lodged 
in  the  lower  part  of  the  intestines,  which  is  the  habit  of  the  ascarides. 
The  digestion  must  be  supported  by  proper  food,  and  by  the  remedies 
which  strengthen  the  stomach.  And  a  diligent  attention  is  requisite,  that 
no  superfluous  matter  be  retained  in  the  bowels:  for  wherever  there  is 
nourishment  convenient  for  their  growth,  thither  the  seeds  of  plants, 
thither  the  eggs  of  animals  are  presently  conveyed. 

CHAPTER  16 
OF  VOMITING 

Vomiting  is  often  an  attendant  on  other  complaints;  sometimes  of 
itself  it  constitutes  an  original  disease.  It  is  moreover  either  crude,  or 
concocted.  When  what  has  been  taken  is  returned  crude  and  unaltered, 
it  may  be  suspected  to  arise  from  over  feeding,  and  to  require  nothing 
more  than  temperance  for  its  cure.  For  a  vomiting  of  digested  food,  it  is 
right  to  change  the  mode  of  diet;  or  to  open  the  body  by  some  gentle 
physic;  also  to  clear  the  stomach  by  an  emetic,  and  afterwards  to  make 
the  patient  drink  a  little  mint  tea,  or  a  saline  draught,  to  which  may  be 
added  one  drop  of  tincture  of  opium.  Others  derive  benefit  from  a  few 
grains  of  oyster-shell  powder,  or  from  a  decoction  of  the  Peruvian  bark 
taken  twice  a  day:  sometimes  also  the  warm  bath  is  of  service,  sometimes 
a  liniment,  sometimes  a  blister,  or  other  plaster,  applied  over  the 
stomach. 

It  is  a  common  notion  that  the  puking  of  infants  is  a  mark  of  health : 
which  I  imagine  must  have  originated  from  hence,  that  a  healthy 
stomach  is  capable  of  exerting  itself  with  more  energy,  and  of 
expelling,  either  upwards  or  downwards,  any  superfluous  or  un- 
wholesome substances  it  may  have  received.  On  the  other  hand,  they 
who  are  weaker,  from  their  very  want  of  strength  retain  what  has  been 
swallowed,  and  grow  sick,  because  they  are  not  able  to  unload  and  relieve 
themselves. 

CHAPTER  17 

OF  THE  STATE  OF  THE  BOWELS 

A  costive  habit  of  the  body*  while  it  is  not  to  be  wished  for,  so  neither 
is  it  too  much  to  be  dreaded.  For  a  loose  state  of  the  bowels  rather  indi- 
cates a  weak  constitution,  and  a  confined  state  a  strong  one.  But  in  this  a 
moderation  is  to  be  observed;  and  if  an  infant  pass  six-and-thirty  hours 
without  a  motion,  some  purgative  medicine  ought  to  be  administered. 


536  PEDIATRICS  OF  THE  PAST 

CHAPTER  1 8 

OF  A  LOOSENESS  OF  THE  BOWELS 

A  looseness  of  the  bowels  in  children  may  arise  from  various  causes; 
but  seems  to  me  to  be  frequently  occasioned  either  by  too  much,  or  by 
unsuitable  food.  Therefore  to  the  choice  and  regulation  of  this  a  diligent 
attention  should  be  given.  And  as  these  disorders  often  subside  of  them- 
selves without  any  remedies,  it  is  generally  expedient  to  wait  at  least  the 
space  of  one  day,  before  recourse  is  had  to  medicine.  The  autumn  is  the 
season  most  liable  to  these  complaints.  A  change  of  place,  which  has 
sometimes  appeared  to  bring  on  a  looseness,  has  at  other  times  contrib- 
uted to  its  removal.  In  some  cases  an  emetic  is  useful:  in  almost  all  as 
much  rhubarb  as  will  move  the  body,  and  afterwards  the  prepared  chalk, 
or  oyster-shell  powder,  and  spices,  and  bitters,  and  astringents.  In  many 
likewise  it  is  necessary  to  repeat  the  rhubarb  several  times  at  moderate 
intervals,  when  the  stools  are  not  only  loose,  and  more  frequent  than  they 
ought  to  be,  but  are  besides  slimy,  or  tinged  with  blood,  or  otherwise 
bad.  Under  these  circumstances  it  will  be  proper  every  second  or  third 
day  to  clear  the  bowels  by  some  gentle  purgative,  and  in  the  mean  time 
to  give  such  things  as  will  control  and  confirm  them,  and  refresh  the 
strength.  The  food  also  should  be  of  that  kind,  which  may  at  once  both 
nourish  the  body,  and  check  the  disease.  Of  this  description  are  rice,  or 
flour  boiled  in  milk,  or  jelly  of  hartshorn,  or  isinglass,  with  a  little  wine  and 
sugar.  Sometimes  glutinous  substances  are  of  service  to  sooth  the  irri- 
table state  of  the  intestines,  as  the  pulvis  tragacanthae  compositus,  or  a 
tablespoonful  of  suet  put  into  a  quarter  of  a  pint  of  milk  while  it  is  yet 
boiling,  and  stirred  till  it  be  dissolved,  and  then  made  palatable  with  a 
little  sugar.  Some  things  also  may  be  thrown  up  in  a  clyster,  as  a  few 
ounces  of  fat  broth,  or  starch  mucilage,  and  with  these  six  drops  of  tinc- 
tura  opii.  While  the  strength  and  appetite  continue,  a  purging  may  be 
considered  as  free  from  danger.  A  tightness  of  the  skin  accompanied  with 
clay-like  stools  is  commonly  fatal. 


CHAPTER  19 

OF  THE  DESCENT  OF  THE  FUNDAMENT 

It  sometimes  happens  that  a  portion  of  the  intestine  is  pushed  out 
beyond  the  external  orifice  after  every  stool.  This  generally  arises  either 
from  a  looseness  of  the  bowels,  or  from  a  stone  in  the  bladder,  or  from  a 
diseased  state  of  the  intestine.  These  therefore  being  cured,  the  other 
will  easily  subside.  In  some,  weakness  alone  seems  to  have  produced 
this  complaint:  in  which  case,  whatever  strengthens  either  the  body 


THE  HERBERDENS  537 

generally,  or  those  parts  in  particular,  will  be  of  service ;  as  the  Angustura, 
or  Peruvian  bark,  and  cold  bathing.  As  soon  as  the  intestine  is  replaced, 
a  fomentation  should  be  applied,  which  is  made  by  boiling  an  ounce  of 
oak  bark  in  a  pint  of  water. 

The  intestine  is  less  apt  to  come  down,  when  a  seat  is  provided  of 
such  a  height,  that  the  feet  may  not  touch  the  ground  while  the  body 
empties  itself. 

CHAPTER  20 
OF  THE  ERYSIPELAS  OF  CHILDREN 

A  disease  bearing  some  affinity  to  the  erysipelas,  sometimes  children 
in  the  first  month,  especially  those  who  are  born  in  public  hospitals. 
The  mildest  species  of  it  arises  sometimes  in  the  fingers  and  hands,  some- 
times in  the  feet  or  ankles;  where  it  is  presently  followed  by  ulceration. 
There  is  a  worse  kind,  which  begins  near  the  pubes,  from  whence  it 
spreads  upon  the  belly  and  thighs.  Wherever  it  is  formed  the  skin 
becomes  livid  and  hard:  there  is  not  much  swelling,  but  the  parts  which 
are  affected  by  it  have  a  tendency  to  gangrene,  especially  the  scrotum 
in  boys,  and  at  the  same  time  the  penis  is  distended.  It  often  proves 
fatal  in  a  few  days.  When  the  body  has  been  opened  after  death,  the 
intestines  have  been  found  glued  together,  and  covered  with  coagulable 
lymph. 

The  bark  should  be  given  as  soon  as  possible  either  by  the  mouth,  or 
thrown  up  in  a  clyster;  and  to  this  may  be  added  a  little  of  the  confectio 
aromatica,  or  one  or  two  drops  of  tinctura  opii.  Besides,  the  parts  them- 
selves should  be  fomented  with  a  decoction  of  camomile  flowers,  or  with 
the  spiritus  camphoratus. 

CHAPTER  21 
OF  A  DISEASE  ATTENDED  WITH  HARDNESS  OF  THE  SKIN 

(Called  by  the  French  physicians  "L'endurcissement  du  tissu 
ceIIuIaire.,,  See  Hist,  de  la  Soc.  Roy.  de  Medecine,  1784.) 

Another  very  formidable  disease  is  described,  which  has  sometimes 
been  denominated  from  the  peculiar  hardness  of  the  cellular  membrane. 
It  is  rarely  seen  excepting  in  the  crowd  of  a  public  hospital;  and  has  been 
more  frequent  on  the  continent  than  with  us.  The  skin  becomes  tight 
and  hard,  and  as  it  were  fixed  to  the  flesh  beneath,  especially  on  the 
cheeks  and  extremities,  and  about  the  pubes.  The  colour  is  often  yellow- 
ish, like  wax;  sometimes  red  or  livid.  There  is  a  remarkable  coldness 
attending  it,  and  the  cry  of  the  child  is  feeble  and  plaintive.  It  is  usual 
for  several  to  be  attacked  about  the  same  time,  principally  those  who 


538  PEDIATRICS  OF  THE  PAST 

have  been  disordered  in  their  bowels.  In  some  it  has  been  attended  with 
convulsions,  or  locked  jaw;  and  has  sometimes  appeared  within  an  hour 
after  the  birth.  Those  whom  it  attacks,  it  generally  destroys  in  a  few 
days.  On  examining  the  dead  body,  every  part  has  appeared  turgid,  and 
the  cellular  membrane  has  been  filled  with  an  hard  fat. 

Experience  has  taught  us  very  little  concerning  the  cure  of  so  fatal  a 
disorder.  It  may  be  tried  what  removal  into  a  purer  air,  and  frequent 
frictions,  and  warm  bathing,  and  injections  into  the  intestines  can  avail. 

CHAPTER  22 
OF  THE  TETANUS,  OR  LOCKED  JAW 

The  locked  jaw  of  infants,  which  is  extremely  rare  in  England,  is  said 
to  occur  in  some  countries  not  unfrequently.  It  comes  on  suddenly 
between  the  sixth  and  ninth  day  from  the  birth,  and  most  always  proves 
fatal. 

Hyacinthus  Andreas  has  described  this  complaint  as  very  common  in 
Barcelona;  and  Cleghorn,  who  has  preserved  this  account  of  Andreas, 
himself  met  with  the  same  disorder  in  Minorca;  it  is  described  by  Hillary 
as  prevailing  in  the  West  Indies,  and  other  hot  countries;  by  Rush  in 
North  America;  and  by  Macaulay  in  Saint  Kilda,  one  of  the  western  isles 
of  Scotland. 

If  at  any  time  there  be  room  for  the  application  of  remedies,  the 
following  may  deserve  to  be  tried:  the  warm  bath,  frictions,  injections 
into  the  intestines,  and  blisters;  and  to  these  may  be  added  the  cold 
bath. 

CHAPTER  23 

OF  A  DIFFICULTY  OF  MAKING  WATER 

For  a  difficulty  of  making  water,  the  proper  remedies  are  the  warm 
bath,  frictions  of  the  belly,  and  gentle  purgatives;  also  equal  parts  of 
milk  and  warm  water  injected  into  the  intestines. 

CHAPTER  24 

OF  AN  INCONTINENCE  OF  URINE 

A  disease,  the  opposite  to  the  preceding,  is  the  inability  to  retain  the 
urine.  This  is  a  frequent  complaint  in  children  of  both  sexes,  who  are  of 
a  delicate  frame  and  tender  age.  It  is  most  apt  to  be  troublesome  in  the 
night.  In  some  it  continues  for  several  years;  more  commonly  when  the 
age  is  a  little  advanced,  it  subsides. 


THE  HERBERDENS  539 

Sometimes  the  cold  bath  is  of  use,  sometimes  a  blister  plaster  applied 
to  the  loins;  frequently  all  remedies  are  unavailing.  It  is  proper  to  anoint 
the  neighboring  parts  with  any  soft  ointment,  to  prevent  the  skin  from 
chafing  in  consequence  of  being  often  wet. 

CHAPTER  25 
OF  RUPTURES 

It  is  usual  with  infants  to  have  the  navel  prominent.  Sometimes  a 
portion  of  the  intestine  protrudes  further  than  it  ought,  and  requires  to 
be  kept  in  by  a  bandage  till  the  parts  are  consolidated. 

For  that  species  of  rupture,  which  arises  in  the  groin,  no  remedies 
ought  at  first  to  be  applied.  Some  physicians  however  direct  that  the 
patient  should  be  bathed  in  cold  water.  About  the  end  of  the  second  year, 
and  not  sooner,  a  truss  will  be  proper. 

CHAPTER  26 

OF  THE  HYDROCELE 

Children  from  the  earliest  infancy  are  liable  to  the  hydrocele.  But 
the  fluid  is  generally  absorbed  spontaneously,  and  seldom  returns. 
It  is  sufficient  to  moisten  the  part  now  and  then  with  cold  water,  either 
alone,  or  in  which  some  sal  ammoniac  is  dissolved.  Sometimes  however 
it  is  necessary  to  pierce  the  scrotum,  in  order  to  draw  off  the  water. 

CHAPTER  27 

OF  THE  HYDROCEPHALUS,  OR  WATERY  HEAD 

The  hydrocephalus  is  sometimes  formed  before  the  birth;  in  which 
case  the  brain  is  often  extenuated  in  such  a  manner  as  to  resemble  a 
membrane;  at  the  same  time  the  bones  of  the  skull,  not  being  yet  consoli- 
dated, are  distended  to  a  prodigious  size.  Children  in  this  state  rarely 
survive  four  years.  Another  species  of  this  disorder  arises  most  commonly 
between  the  ages  of  two  and  ten  years,  and  is  less  easily  recognized.  In 
both  a  watery  fluid  is  collected  in  the  ventricles  of  the  brain.  It  has 
sometimes  been  suspected  to  have  originated  from  a  blow;  more  fre- 
quently it  has  come  on  without  any  manifest  cause.  I  once  attended  a 
boy  about  ten  years  old,  who  died  of  the  hydrocephalus,  and  who  told 
me  he  had  lost  two  brothers  and  two  sisters  by  the  same  disease.  In 
another  family  we  read  of  six  children  who  were  successively  destroyed 
by  it  at  the  age  of  two  years.  (Underwood,  on  the  Diseases  of  Infants.) 


540  PEDIATRICS  OF  THE  PAST 

Of  this  latter  form  of  the  disease  the  following  are  the  principal  signs: 
fever,  sudden  pains  in  the  head,  shrieking,  frequent  motion  of  the  hands 
towards  the  head,  sickness  at  the  stomach,  heaviness,  impatience  of 
light,  flushing  of  the  cheeks,  delirium,  dilatation  of  the  pupils,  blindness, 
a  slow  pulse,  and  sometimes  stupor,  sometimes  convulsions,  lastly,  death 
for  the  most  part  within  a  month. 

Against  the  hydrocephalus  no  certain  cure  has  been  discovered.  Most 
physicians  give  mercury  in  such  a  manner  as  to  produce  a  salivation; 
which  may  either  be  done  by  means  of  the  ointment,  or  by  two  grains 
of  calomel  taken  every  night.  Medicines  have  been  given  to  excite 
vomiting,  and  purging;  and  in  many  a  discharge  has  been  kept  up  near 
the  head  by  blisters.  But  these,  and  all  other  remedies,  usually  frus- 
trate our  expectations. 

CHAPTER  28 

OF  CONVULSIONS 

It  is  a  common  thing  for  infants  to  have  convulsion  fits;  which  are 
often  entirely  free  from  danger.  Sometimes  however  they  are  occasioned 
by  disorders  of  the  most  formidable  kind,  and  are  only  terminated  by 
death.  They  may  be  brought  on  by  worms,  teething,  indigestion,  and 
whatever  more  than  ordinarily  irritates  the  nerves.  Some  are  convulsed 
in  the  very  first  hours  of  their  life;  especially  those  who  are  born  pre- 
maturely, or  in  whom  the  vital  spark  is  from  any  cause  weak  and 
imperfect.  Danger  is  to  be  apprehended  when  the  intervals  between 
the  fits  are  short. 

A  little  warm  milk,  or  oil,  should  be  thrown  up  into  the  intestines, 
or  something  given  which  may  gently  move  them.  The  warm  bath, 
blisters,  and  frictions  are  also  proper.  Sometimes  the  camphor  mixture 
is  useful;  or  two  drops  of  the  rectified  oil  of  amber,  or  of  the  oleum  ani- 
male,  or  six  drops  of  the  tinctura  opii  camphorata.  Any  of  these  may  be 
repeated  every  four  hours. 

CHAPTER  29 
OF  THE  TEETH 

The  first  set  of  teeth  are  mostly  cut  from  the  sixth  to  the  twentieth 
month.  At  the  same  time  it  is  usual  for  symptoms  to  occur,  which,  in 
different  subjects,  are  more  or  less  violent.  These  are,  an  increased  flow 
of  saliva,  swelling  and  inflammation  of  the  gums,  flushing  of  the  cheeks, 
loose  stools,  wakefulness,  disturbed  sleep,  sudden  fits  of  crying,  putting 
the  fingers  to  the  mouth,  convulsions,  and  fever. 

A  light  and  cool  diet  is  proper,  and  such  things  as  will  keep  the  body 
moderately  open.  Besides  these,  some  divide  the  gums  with  a  lancet. 


i 


THE  HERBERDENS  541 

CHAPTER  30 

OF  THE  DISORDERS  OF  THE  EYES 

Infants  not  infrequently  suffer  inflammation  of  the  eyes;  which 
generally  subsides  itself  without  any  trouble.  When  however  it  continues 
longer,  it  will  be  right  to  give  some  opening  physic,  likewise  to  apply 
leeches  to  the  temples,  or  a  blister  plaster  to  the  back  of  the  neck.  Also 
a  poultice  of  bread  and  milk  inclosed  in  a  fold  of  cambric,  and  tied  around 
the  eye,  is  often  of  great  use.  Besides  these,  some  advise  one  or  two  drops 
of  laudanum  to  be  dropped  into  the  eye  twice  in  the  day.  After  some  time, 
when  the  inflammation  is  gone  off,  and  there  remains  a  weakness  from 
relaxation,  the  eye  may  be  washed  either  with  cold  water,  or  with  a 
mixture  containing  four  ounces  of  distilled  water  and  half  an  ounce  of 
Goulard  water,  or  the  same  quantity  of  distilled  water  with  four  grains 
of  the  cerussa  acetata,  or  with  as  much  white  vitriol.  And  if  the  eyelids 
adhere  together,  as  is  often  the  case,  their  edges  ought  to  be  anointed 
every  night  with  some  soft  and  mild  ointment. 

It  is  a  more  rare  complaint,  in  which  there  arises,  a  few  days  after  the 
birth,  a  great  swelling  of  the  eyelids,  so  as  completely  to  close  the  sight, 
while  at  the  same  time  a  purulent  humour  oozes  out  from  the  coats  of  the 
eye  beneath.  Sometimes  the  eye  itself  is  destroyed.  The  proper  remedy  is 
to  clean  the  surface  of  the  eye  several  times  a  day  with  a  wash  composed 
of  four  ounces  of  distilled  water  and  one  dram  either  of  the  aqua  aluminis 
composita,  or  of  the  aqua  zinci  vitriolati  cum  camphora. 

When,  in  consequence  of  a  violent  degree  of  inflammation,  or  from 
any  other  accident,  there  remains  a  white  speck,  it  may  sometimes  be 
removed  by  dropping  into  the  eye  three  times  a  day  two  drops  of  a  liquor 
consisting  of  four  ounces  of  distilled  water  in  which  is  dissolved  one  grain 
of  hydrargyrus  muriatus. 

No  operation  ought  to  be  attempted  for  the  removal  of  a  cataract 
during  infancy. 

For  that  species  of  blindness  which  is  called  a  gutta  serena,  in  which 
the  pupil  is  clear,  but  dilated,  and  unaltered  by  the  admission  of  light, 
some  recommend  electricity,  some  the  opening  of  a  drain  in  the  neck, 
some  calomel.  For  my  own  part,  I  have  but  too  often  found  all  remedies 
fruitless. 

CHAPTER  31 

OF  SQUINTING 

When  a  child  is  born  with  the  eyes  turned  in,  the  deformity  usually 
continues.  But  that  squinting,  which  comes  on  afterwards,  may  often  be 
cured.  The  only  remedy  is,  to  cover  the  sound  eye,  for  a  few  days,  with  a 
close  bandage. 


542  PEDIATRICS  OF  THE  PAST 

CHAPTER  32 

OF  BLEEDING  AT  THE  NOSE 

A  bleeding  of  the  nose  is  not  uncommon  in  children,  particularly  if 
they  are  at  all  weakly,  and  the  weather  is  hot.  It  seldom  requires  any 
remedy;  or  it  is  sufficient  to  apply  some  cold  substance  to  the  back,  or  to 
immerse  the  hands  in  cold  water.  If  the  bleeding  cannot  be  stopt  by  these 
means,  a  pledget  of  lint  must  be  introduced  into  the  nostril,  till  it  reach 
the  orifice  of  the  bleeding  vessel.  When  there  are  frequent  returns  of  the 
disorder,  it  will  be  proper  now  and  then  to  open  the  body  with  some 
purgative  salt. 

CHAPTER  33 

OF  BLEEDING  FROM  THE  PRIVATE  PARTS 

It  sometimes  happens  that  blood  is  discharged  from  the  private  parts 
of  female  infants  within  a  few  days  from  their  birth,  and  generally  occa- 
sions alarm,  though  without  reason;  for  it  subsides  of  itself,  and  is  fol- 
lowed by  no  ill  consequences. 

CHAPTER  34 

OF  THE  FLUOR  ALBUS 

A  copious  white  discharge  sometimes  occurs  in  children  of  five 
years  old.  Frequent  washing  is  useful,  and  such  medicines  as  gently 
move  the  body.  It  is  likewise  proper  to  use  the  cold  bath,  and  to  take 
the  decoction  of  bark,  and  whatever  will  add  firmness  and  strength  to 
the  habit. 

CHAPTER  35 

OF  A  COLD  IN  THE  HEAD 

The  effects  of  a  common  cold  are  often  troublesome  to  children, 
particularly  to  infants  at  the  breast.  For  while  they  are  sucking,  if  the 
breath  cannot  be  drawn  through  the  nose,  it  is  almost  stopt.  Therefore 
the  nostrils  ought  to  be  cleared,  and  afterwards  anointed  with  the  sper- 
maceti, or  other  soft  ointment.  At  the  same  time,  if  there  is  much  humour 
discharged,  it  will  be  right  to  give  some  opening  physic,  or  to  apply  a 
blistering  plaster  to  the  neck. 

CHAPTER  36 

OF  A  COUGH 

For  the  cure  of  a  cough  it  is  often  expedient  to  take  away  blood  from 
the  arm,  especially  if  the  disorder  is  attended  with  pain,  and  shortness 


THE  HERBERDENS  543 

of  breath.  Should  a  child  be  too  young  to  admit  of  such  an  operation, 
two  or  more  leeches  may  be  applied  to  the  arm,  or  a  vein  may  be  opened 
in  the  neck.  The  body  ought  at  the  same  time  to  be  purged,  and  a  blister- 
ing plaster  should  be  applied  either  to  the  breast,  or  to  the  back;  which 
is  the  more  necessary,  if  there  happen  to  be  much  defluxion  upon  the 
chest.  In  addition  to  these  remedies,  the  cough  will  admit  of  some 
alleviation  from  sipping  occasionally  emulsions,  or  other  soft  liquors. 
Also  five  drops  of  antimonial  wine  may  be  given  in  a  little  liquorice 
tea;  or  ten  drops  of  the  syrup  of  white  poppies  several  times  in  the  day, 
or  a  dram  at  bed-time.  Lastly,  the  body  must  be  kept  open,  and  all 
strong  food  must  be  withheld.  When  the  disease  is  protracted,  the 
patient  should  be  directed  to  change  the  air,  and  to  drink  asses'  milk. 

CHAPTER  37 
OF  THE  HOOPING  COUGH 

The  hooping  cough,  mild  at  its  commencement,  is  soon  increased; 
and  with  it  the  food,  or  a  thick  phlegm,  is  commonly  thrown  up;  by 
which  signs  this  disorder  is  at  first  detected.  After  a  little  while,  the  breath, 
almost  spent  by  the  violence  of  the  cough,  is  drawn  again  with  a  peculiar 
sound,  which  constitutes  the  distinguishing  mark  of  the  disease.  It  is 
accompanied  by  little  or  no  fever.  The  fits  come  on  suddenly,  and  ter- 
minate abruptly:  when  they  are  past,  children  scarcely  seem  to  be  at 
all  unwell;  although  a  moment  before  they  had  been  almost  suffocated; 
for  the  face  is  swelled  and  purple,  the  eyes  are  filled  with  water,  the 
stomach  is  oppressed  with  wind,  and  sometimes  blood  is  forced  from  the 
mouth  or  nose.  It  is  a  disease  distressing  both  by  its  vehemence,  and  by 
its  continuance;  but  seldom  dangerous,  except  to  very  young  children. 

It  is  universally  known  how  easily  the  contagion  of  this  cough  spreads. 
In  some  it  has  shewn  itself  about  fourteen  days  after  they  had  been 
exposed  to  it;  in  others  rather  sooner.  Those  who  have  once  had  it,  are 
generally  secure  for  the  remainder  of  their  lives. 

When  the  stomach  appears  to  be  loaded  with  much  phlegm,  it  is 
proper  to  excite  it  to  vomit;  for  which  purpose,  five  grains  of  ipecacuanha 
are  useful,  or  one  or  two  drams  of  a  mixture  containing  two  ounces  of 
water,  two  scruples  of  sugar,  and  two  grains  of  tartarised  antimony: 
in  others  it  is  sufficient  now  and  then  to  move  the  body  with  a  little 
rhubarb,  or  jalap.  The  food  and  drink  ought  to  be  light;  and  at  night 
it  is  often  of  service  to  give  two  drops  of  the  tinctura  opii,  or  a  dram  of 
the  syrup  of  white  poppies;  to  either  of  which  may  be  added  five  drops 
of  antimonial  wine.  Some  also  recommend  the  antimonial  wine,  or 
the  inspissated  juice  of  the  hemlock,  to  be  taken  several  times  in  the 
day.  Others  rub  the  back  and  breast  with  a  liniment  containing  the  oil 


544  PEDIATRICS  OF  THE  PAST 

of  amber.  But  most  of  all,  a  frequent  change  of  place  is  found  to  be 
beneficial.  In  this  species  of  cough  it  is  seldom  necessary  to  take  away 
blood;  but  if  there  comes  on  a  shortness  of  breath,  a  blistering  plaster 
ought  to  be  applied. 

CHAPTER  38 
OF  THE  CROUP 

The  croup  is  an  acute  and  dangerous  disease,  which  is  mostly  met 
with  in  children  under  twelve  years  of  age.  It  is  attended  with  difficulty 
of  breathing,  and  the  breath  being  obstructed  in  its  passage,  is  uttered 
with  a  quick  and  shrill  sound,  which  characterizes  the  complaint.  The 
pulse  is  at  the  same  time  accelerated,  and  there  is  usually  a  cough;  some- 
times also  a  little  mucus  is  forced  up.  And  sometimes  the  upper  part  of 
the  wind-pipe  is  slightly  painful,  and  is  externally  swelled.  It  often  comes 
on  at  intervals  in  distressful  fits,  which  the  patients  foresee,  and  dread: 
and  some,  after  they  are  past,  seem  to  be  quite  spent  and  exhausted,  in 
which  state  they  may  lie  for  an  hour,  or  for  several  hours.  It  is  doubtful 
whether  this  disease  is  contagious,  or  not;  also  whether  it  attacks  the 
same  person  more  than  once;  or  whether  it  is  more  frequent  on  the  sea 
coast,  or  in  wet,  or  cold  seasons.  It  had  scarcely  been  noticed  till  towards 
the  latter  part  of  the  eighteenth  century. 

On  opening  the  dead  body,  the  trachea  has  been  found  inflamed,  and 
lined  throughout  its  whole  extent  with  a  tenacious  mucus,  as  it  were  with 
a  membrane. 

At  first,  or  when  there  is  much  fever,  it  may  afford  relief  to  take  away 
blood,  either  by  the  lancet,  or  by  leeches  applied  to  the  breast.  In  all 
cases,  a  blistering  plaster  ought  to  be  put  on.  Sometimes  a  vomit  is  useful, 
and  squills,  and  antimony,  and  gum  ammoniacum,  and  asa  foetida,  either 
taken  by  the  mouth,  or  thrown  up  in  a  clyster,  which  may  alleviate  the 
laborious  breathing;  likewise  warm  vapours  received  into  the  throat; 
nor  is  it  inexpedient  to  give  a  few  drops  of  the  syrup  of  white  poppies, 
or  of  the  camphorated  tincture  of  opium.  If  a  child  is  seized  while  he  is 
lying  down,  he  should  immediately  be  raised  up,  lest  he  be  suffocated  by 
the  violence  of  the  attack.  During  this  disease  the  food  should  be  of  the 
thinnest  and  mildest  kind. 

CHAPTER  39 

OF  THE  ULCERATED  SORE-THROAT 

The  ulcerated  sore-throat  is  one  of  those  diseases  which  are  most 
readily  communicated  among  children  by  infection:  it  is  also  not  infre- 
quently fatal.  In  this  complaint  the  throat  is  painful,  swelled,  red,  and 
ulcerated;  at  the  same  time  there  is  an  acute  fever,  great  loss  of  strength, 


THE  HERBERDENS  545 

and  often  delirium.  Likewise  the  breast  and  arms,  or  the  whole  body,  is 
in  most  suffused  with  a  red  colour.  And  sometimes  a  sharp  humous  is 
discharged  from  the  mouth  and  nose.  If  in  addition  to  these  there  comes 
on  a  difficulty  of  breathing,  it  is  unfavourable.  It  very  rarely  attacks  any 
person  a  second  time. 

In  this  disease  all  strong  purgatives  ought  to  be  avoided.  A  plaster  of 
cantharides  is  almost  always  useful,  and  whatever  will  support  the  sinking 
strength,  as  the  Peruvian  bark,  in  powder,  or  decoction,  to  which  may  be 
added  a  little  of  the  aromatic  tincture,  or  confection.  The  throat  also 
should  be  gargled  with  the  infusion  of  roses,  or  with  a  mixture  containing 
honey  and  vinegar  and  port  wine.  A  little  wine  likewise  in  the  patient's 
gruel,  or  other  drink,  is  often  salutary. 

CHAPTER  40 
OF  THE  SCARLET  FEVER 

The  scarlet  fever  is  attended  with  the  common  signs  of  fever;  besides 
which,  the  breast  and  arms,  or  the  whole  skin  is  unusually  red.  This 
colour  is  either  uniformly  diffused,  or  is  in  detached  spots.  The  subjects 
of  this  disorder  have  an  extraordinary  degree  of  Iangour,  and  are  often 
light-headed;  at  the  same  time  most  complain  of  soreness  in  the  throat. 
Moreover  the  glands  under  the  ears,  or  elsewhere,  often  swell,  and  some- 
times suppurate.  When  the  disease  is  past,  the  whole  skin  is  renewed. 
They  who  have  once  gone  through  the  scarlet  fever  are  generally  secure 
for  the  rest  of  their  lives. 

This  disease,  and  the  ulcerated  sore-throat,  if  they  are  not  one  and 
the  same,  at  least  require  the  same  method  of  cure.  Therefore  in  this 
case  likewise  we  ought  to  use  the  decoction  of  bark,  and  spices,  and  wine, 
and  blisters;  and  to  support  the  vital  powers  by  every  means. 

Both  diseases  usually  show  themselves  about  the  sixth  day  after  they 
have  been  contracted. 

It  is  a  point  of  great  importance  to  determine  how  soon  after  this 
disease  patients  may  be  restored  to  their  family  without  danger  of  com- 
municating infection.  I  have  known  some  children  return  to  the  society 
of  their  brothers  and  sisters  the  fifth  day  from  the  termination  of  the 
redness,  the  skin  having  been  first  thoroughly  washed  with  warm  water, 
and  all  their  clothes  changed,  and  no  harm  has  ensued. 

CHAPTER  41 

OF  THE  MEASLES 

The  signs  of  measles  are  these.  A  fever,  a  dry  cough,  watery  and  weak 
eyes,  swelling  of  the  eye-lids,  sneezing.  These  precede  the  eruption  about 


546  PEDIATRICS  OF  THE  PAST 

three  days.  Generally  on  the  fourth  day  there  come  out  small  red  spots, 
first  on  the  face,  and  the  day  following  on  the  arms  and  rest  of  the  body: 
after  four  days  more,  they  die  away  into  a  branny  scurf;  and  presently 
all  the  symptoms  subside.  In  a  few,  at  this  period,  the  fever  and  restless- 
ness increase;  and  sometimes  a  speedy  death,  sometimes  a  slow  decline 
follows. 

The  cough,  and  difficulty  of  breathing,  may  require  bleeding  on  any 
day  of  the  disease.  Besides,  by  cooling  diet  and  medicines,  the  heat  and 
fever  is,  as  much  as  possible,  to  be  mitigated.  To  procure  sleep,  a  dram  of 
the  poppy  syrup,  or  three  or  four  drops  of  the  tincture  of  opium,  are  often 
necessary.  Lastly,  when  the  disease  is  past,  some  opening  physic  should 
be  administered. 

This  disorder  lies  concealed  in  the  habit  sometimes  ten,  sometimes 
fourteen  days  before  it  shews  itself. 

CHAPTER  42 

OF  THE  SMALL-POX 

Since  the  practice  of  inoculation  has  been  generally  adopted, 
the  small-pox  has  been  to  be  reckoned  among  the  diseases  of  childhood. 
I  shall  therefore  point  out,  first,  what  age  is  best  suited  to  it;  then,  what 
are  its  usual  signs;  and  lastly,  what  is  the  proper  method  of  treatment. 
But  since  the  proportion  of  those  who  die  is  sixty  times  greater  by  the 
natural  disease,  than  by  that  produced  by  inoculation ;  it  is  evident  that 
this  ought  at  any  time  to  be  performed,  provided  there  be  danger  of 
incurring  the  other.  However,  they  who  reside  in  the  country,  and  are 
therefore  less  exposed  to  the  contagion  of  the  small-pox,  may  safely 
wait  till  they  have  completed  their  second  year.  On  the  other  side  the 
sixth  ought  not  to  be  past  without  inoculation.  For  this  purpose  nothing 
more  is  necessary,  than  to  insert  the  point  of  a  needle,  or  lancet,  imbued 
with  the  variolous  matter,  obliquely  under  the  cuticle  of  either  arm, 
half  way  between  the  shoulder  and  elbow.  Generally  on  the  fourth  day 
afterwards  the  puncture  is  sensibly  elevated,  and  from  that  time  rapidly 
increases.  On  the  ninth  there  comes  on  a  fever,  and  the  same  evening 
some  have  one  or  more  convulsion  fits.  I  n  the  course  of  the  three  follow- 
ing days  the  eruption  is  completed;  and  in  three  days  more  the  pustules 
become  ripe  and  full  of  matter,  and,  if  their  number  be  considerable,  a 
fever  is  again  lighted  up:  soon  after,  they  grow  dry,  and  fall  off;  exhibit- 
ing an  illustrious  instance  of  the  vanity  of  human  wisdom,  which,  after 
having  been  long  baffled  by  this  disease,  has  been  obliged  to  take  refuge 
in  the  invention  of  barbarous  nations.  Since  then  we  now  see  children  so 
slightly  affected  by  the  small-pox,  there  seems  to  be  little  occasion  for 
medicine,  or  for  much  alteration  from  their  ordinary  habits.  Yet  a  short 
abstinence  from  animal  food,  and   a  little  gentle  physic,   will   not  be 


THE  HERBERDENS  547 

improper,  especially  if  the  patient  be  full,  or  in  any  manner  heated.  It 
will  again  be  right  to  empty  the  bowels  as  soon  as  the  pustules  have  fallen 
from  the  face.  But  if  the  eruption  be  more  abundant  than  usual,  and 
create  greater  uneasiness,  it  will  be  beneficial  frequently  to  sip  any  thin 
liquids,  and  to  take  half  a  dram  of  the  syrup  of  white  poppies,  or  two 
drops  of  tincture  of  opium,  at  bed  time,  or  even  through  the  day.  Often 
likewise  it  is  equivalent  to  all  other  remedies,  to  refresh  the  hot  and 
feverish  body  by  taking  it  into  the  cool  air.  The  rest  of  the  cure  must  be 
conducted  in  the  same  manner  as  in  other  fevers.  Therefore,  when  the 
strength  is  oppressed,  and  struggling  as  it  were  with  the  disease,  the 
bowels  ought  to  be  cleared,  or  a  blistering  plaster  should  be  put  on: 
where  there  occurs  much  restlessness,  fomentations,  or  warm  injections, 
or  opiates,  will  sooth  the  wearied  body:  on  the  other  hand,  faintness  and 
languor  are  to  be  relieved  by  wine,  and  aromatics,  or  by  the  Peruvian 
bark. 

CHAPTER  43 
OF  THE  COW-POX 

Towards  the  close  of  the  eighteenth  century  a  new  disorder,  bearing 
some  affinity  to  the  small-pox,  was  made  public;  which,  as  it  derived  its 
origin  from  the  teats  of  cows,  received  from  thence  its  name.  The  cow- 
pox,  whether  casually  or  designedly  ingrafted  on  the  human  body,  seems 
to  render  it  secure  against  the  small-pox;  although  itself  be  distinguished 
from  this  disorder  by  unequivocal  marks.  For  it  is  not  communicated  by 
contagion;  and  it  occasions  no  eruption  over  the  body;  and  for  the  most 
part  excites  no  fever.  But  there  arises  one  round  pustule  on  the  inocu- 
lated part,  which  generally  on  the  sixth  day  from  the  insertion  contains  a 
thin  fluid;  on  the  tenth  day  is  surrounded  by  a  circular  red  areola;  and  on 
the  twelfth  day  begins  to  dry  up  into  a  dark  and  deep  scab. 

It  is  of  importance  to  attend  to  this  progress  of  the  disease;  since  it  is 
from  hence,  that,  in  the  present  state  of  our  knowledge,  we  derive  the 
best  assurance  of  its  having  taken  full  effect. 

CHAPTER  44 

OF  THE  CHICKEN-POX 

The  chicken-pox  comes  on  without  much  fever.  In  the  beginning  the 
eruption  resembles  the  true  small-pox ;  but  the  pustules  increase  faster, 
and  sooner  go  off.  They  likewise  vary  considerably  in  size,  and  are  seldom 
very  numerous.  On  the  first  day  they  are  red;  on  the  second  they  have 
watery  heads;  on  the  third  they  become  yellow,  or  often,  being  broken 
by  scratching,  they  subside;  on  the  fourth,  or  day  following,  they  are 
covered  with  a  thin  scab. 


548  PEDIATRICS  OF  THE  PAST 

The  contagion  of  the  chicken-pox  most  commonly  becomes  manifest 
on  the  eighth  or  ninth  day  after  it  has  been  contracted. 

It  is  not  improper  to  abstain  from  meat  and  wine  for  a  few  days,  and 
at  the  same  time  to  avoid  any  thing  that  may  heat  the  body.  Besides 
these  precautions,  little  or  nothing  is  usually  required. 

CHAPTER  45 
OF  THE  INFANTILE  FEVER 

Children  are  liable  to  a  particular  species  of  fever,  mild  at  its 
commencement,  slow  in  its  progress,  and  uncertain  in  its  event.  When  it 
happens,  they  grow  fretful,  and  some  have  occasionally  shiverings; 
their  lips  become  dry,  their  hands  hot,  their  pulse  quick,  and  their  breath 
short;  they  are  unwilling  to  stir,  or  to  speak;  sometimes  very  little  is 
discharged  from  the  bowels,  sometimes  too  much,  often  slime,  or  mucus, 
or  perhaps  a  worm :  at  the  same  time  the  sleep  is  disturbed,  and  the  food 
is  rejected:  some  are  delirious,  or  lost  and  stupid;  many  for  a  time  are 
speechless. 

The  first  thing  to  be  done  is  effectually  to  clear  the  bowels;  and 
throughout  the  disease  they  ought  to  be  kept  open,  or  now  and  then  to 
be  moved  by  some  purgative  medicine.  Besides,  rest,  and  thin  liquids 
are  to  be  recommended :  lastly,  the  debility  of  the  patient  is  to  be  relieved 
by  a  decoction  of  the  Peruvian  bark,  and  other  remedies  of  a  similar 
kind. 

I  never  had  reason  to  think  this  fever  was  infectious. 

CHAPTER  46 
OF  THE  HECTIC  FEVER 

In  the  hectic  fever  the  strength  insensibly  decays,  the  playful  spirits 
of  children  are  lost,  and  the  whole  body  wastes  away  by  a  slow  consump- 
tion. This  generally  arises  from  some  internal  disease,  to  which,  if  it  can 
be  detected,  our  first  attention  ought  to  be  given.  But  since  the  original 
seat  of  the  disease  is  often  obscure;  or,  if  it  be  not  concealed,  yet  admits 
not  certain  remedy;  it  will  be  sufficient,  by  purgatives  now  and  then 
administered,  to  withdraw  something  from  that  matter  which  seems  to 
offend,  and  at  the  same  time  to  support  the  strength  by  all  the  means  in 
our  power.  And  if  any  one  part,  as  the  bowels,  or  stomach,  is  affected 
more  than  the  rest,  we  must  lose  no  time  in  affording  succour  against  the 
most  pressing  complaint. 

In  most  cases  it  is  useful  to  give  a  few  grains  of  rhubarb  once  on  four 
or  five  days,  and  in  the  mean  time  a  decoction  or  extract  of  the  Peruvian 
bark.  Sometimes  a  change  of  diet  is  beneficial;  or  a  removal  into  a  purer 
air;  likewise  moderate  exercise,  as  the  strength  will  permit. 


THE  HERBERDENS  549 

That  species  of  fever,  which  is  attended  with  swelling  of  the  belly, 
costiveness,  or  sometimes  purging,  and  emaciation,  often  seems  to  pro- 
ceed from  inflammation,  or  obstruction  of  the  mesenteric  glands.  In  this 
case  also  the  treatment  should  be  the  same  that  I  have  described;  except- 
ing that  in  a  confined  state  of  the  body  there  should  be  a  freer  use  of 
purgative  medicines.  Therefore  senna,  or  salts,  or  rhubarb  combined  with 
calomel,  may  be  given  twice  a  week;  and,  on  the  intermediate  days,  an 
ounce  of  the  decoction  of  bark  morning  and  evening,  either  by  itself, 
or  with  the  addition  of  eight  grains  of  the  natron  praeparatum. 

CHAPTER  47 

OF  THE  AGUE,  OR  INTERMITTENT  FEVER 

Children,  as  well  as  grown  people,  are  sometimes  attacked  with  the 
ague,  and  are  cured  by  the  same  remedies.  Therefore,  when  the  fit  is 
approaching,  it  will  be  right  to  give  five  grains  of  ipecacuanha,  and  to 
provoke  a  vomiting,  and  afterwards  to  administer  the  Peruvian  bark. 
This  however  would  not  fall  within  our  view  in  treating  of  the  diseases  of 
childhood,  did  not  some  circumstance  happen  peculiar  to  that  age.  For, 
as  children  cannot  easily  be  induced  to  take  so  much  of  this  drug  as  is 
necessary  for  the  cure  of  the  disease,  it  often  becomes  a  matter  of  consider- 
able difficulty  to  find  out  by  what  means  it  may  be  rendered  more 
tolerable.  This  is  best  effected  by  milk.  In  one  ounce  of  milk  sweetened 
with  a  little  sugar  may  be  given  a  scruple  of  the  powdered  bark,  or  an 
equal  quantity  of  the  extract.  Others,  instead  of  milk,  substitute  the  milk 
of  almonds;  or,  with  the  addition  of  some  syrup,  make  it  into  an 
electuary.  Lastly,  if  none  of  these  can  be  swallowed,  a  clyster  must  be 
thrown  up  three  or  four  times  a  day,  consisting  of  three  ounces  of  the 
decoction  of  bark,  to  which  may  be  added  a  little  either  of  the  powder  of 
extract,  and  three  drops  of  tincture  of  opium,  or  as  much  as  is  necessary 
to  enable  the  bowels  to  retain  the  medicine. 

CHAPTER  48 

OF  THE  VENEREAL  DISEASE 

Women  who  are  infected  with  the  venereal  disease  often  bring  forth 
dead  children.  It  may  be  doubted  whether  this  is  owing  to  the  disorder 
itself,  or  to  the  remedies  necessary  for  its  cure.  Of  those  who  are  born 
alive  from  diseased  parents,  some  enjoy  perfect  health;  in  others  the 
mouth  is  internally  infested  with  ulceration,  and  the  cuticle  of  the  body 
perishes.  They  are  said  also  to  infect  their  nurses  with  superficial  ulcer- 
ations, and  wasting  of  the  flesh  and  strength;  which,  whether  it  should  be 
called  venereal,  or  not,  is  uncertain.  Perhaps  children  who  are  born  of 


550  PEDIATRICS  OF  THE  PAST 

healthy  parents  may  not  be  wholly  exempt  from  similar  disorders.  Sea 
bathing  appears  to  have  afforded  the  best  remedy.  Should  however  any 
child  be  tainted  with  the  real  venereal  disease,  the  mercurial  ointment 
ought  to  be  rub'd  in  without  delay. 

CHAPTER  49 
OF  ERUPTIONS 

Several  kinds  of  eruptions  are  incident  to  children.  Often  there  come 
out  red  scattered  spots,  which  occupy  irregularly  the  face,  or  neck,  or  the 
whole  body:  sometimes  they  are  a  little  raised  above  the  surrounding 
skin,  or  are  filled  with  a  fluid. 

In  another  kind  there  are  formed  scales,  sometimes  attended  with 
moisture,  at  other  times  dry.  These  principally  occur  about  the  forehead. 
But  though  they  may  continue  for  a  considerable  time,  yet  there  is  no 
danger  to  be  apprehended,  and  no  scar  is  left. 

Sometimes  there  arises  an  eruption  of  red  pimples  on  the  neck  and 
face,  or  all  over  the  body,  which  remain  for  three  or  four  days,  and  in 
appearance  resemble  the  scarlet  fever,  or  measles.  But  as  they  are  unac- 
companied with  fever,  I  conceive  them  to  have  no  connection  with  these 
diseases.  And  I  am  the  more  confirmed  in  this  opinion  from  having  seen 
children  broken  out  in  this  manner,  whom  I  had  before  attended  through 
the  scarlet  fever. 

There  are  other  species  of  eruptions,  which  it  would  be  to  no  purpose 
individually  to  describe.  They  all  require  the  body  to  be  kept  open;  and 
if  there  is  any  sickness  at  the  stomach,  a  little  chalk  or  magnesia  ought 
to  be  given,  and  afterwards  some  rhubarb.  But  while  the  health  is 
unaffected,  I  am  of  the  opinion  that  it  is  better  to  abstain  from  medi- 
cines. Cold  is  generally  unfriendly  to  persons  under  these  complaints. 
The  food  should  be  mild  and  of  easy  digestion. 

Against  ;the  more  obstinate  cutaneous  disorders  may  be  applied 
externally  the  decoction  of  white  hellebore,  or  the  unguentum  calcis 
hydrargyri  albae,  or  an  ointment  composed  of  equal  parts  of  the  unguen- 
tum hydrargyri  nitrati,  and  the  unguentum  adipis  suillae.  Internally 
also  may  be  given  occasionally  either  senna  tea,  or  salts,  or  some  other 
purgative;  and  in  the  mean  time  the  body  should  be  strengthened  by  the 
Peruvian  bark. 

CHAPTER  50 

OF  PURPLE  SPOTS 

In  some,  and  principally  in  girls,  mostly  about  their  twelfth  year, 
there  come  out  purple  spots  on  the  neck  and  limbs,  or  all  over  the  body; 
which,  though  they  are  free  from  all  danger,  yet  often  create  unfounded 


THE  HERBERDENS  55* 

alarm;  some  imagining  that  they  are  indicative  of  the  scurvy,  others  of 
putrid  fevers,  or  mortification.  Their  common  appearance  is  that  of 
small,  round,  purple  spots,  amongst  which  are  some  larger  black  and  blue 
marks,  as  if  from  a  bruise.  At  the  same  time  children  are  subject  to 
bleedings  from  the  nose,  or  mouth,  or  other  parts,  which  it  is  not  always 
easy  to  stop.  A  more  rare  occurrence  is  that  of  swellings  arising  on  the 
legs,  of  the  same  colour  as  the  rest  of  the  skin,  which  are  painful  when 
the  limb  is  moved.  No  fever,  nor  even  weakness  is  used  to  be  perceived, 
nor  does  any  bad  consequence  follow. 

It  is  doubtful  whether  medicines  have  any  effect  upon  this  complaint. 
Certainly  the  Peruvian  bark  and  acid  of  vitriol  have  in  several  instances 
been  of  no  service.  It  has  appeared  to  be  attended  with  rather  more 
advantage,  to  move  the  body  now  and  then  with  some  purgative  salt. 
The  disorder  most  commonly  terminates  of  its  own  accord,  sometimes 
after  ten,  sometimes  after  twenty  days;  at  other  times  it  perseveres  for 
three  or  four  months;  or  lastly,  when  it  has  seemed  to  be  past,  it  after  an 
interval  returns.  < 

CHAPTER  51 

OF  SORE  EARS 

It  is  a  frequent  disorder  among  children,  to  have  moisture  and 
ulceration  behind  the  ears.  For  this  astringent  remedies  are  not  proper. 
In  general  it  is  sufficient  to  wash  those  parts  with  warm  water  twice  or 
thrice  in  the  day,  and  afterwards  to  interpose  between  the  ear  and  the 
head  a  piece  of  lint  spread  with  any  soft  cerate. 

If  the  disease  should  extend  down  the  neck  with  pain,  and  should 
penetrate  deeper  into  the  skin,  it  will  be  useful  to  apply  to  it  the 
unguentum  calcis  hydrargyri  albae.  Sometimes  it  is  necessary  to  use 
externally  fomentations,  internally  some  opening  medicine,  repeated  at 
intervals  of  three  or  four  days,  and  in  the  mean  time  the  extract  of 
Peruvian  bark.  Sometimes  a  blister,  by  drawing  the  humour  to  a  different 
part,  is  conducive  to  the  cure. 

CHAPTER  52 

OF  A  CHAFING  OF  THE  SKIN 

In  children,  especially  those  who  are  fat,  and  in  hot  weather,  the 
skin  is  apt  to  chafe,  wherever  there  is  a  fold  in  it,  and  it  is  moist  from  the 
urine,  or  from  perspiration,  or  any  other  cause.  These  parts  ought  several 
times  in  the  day  to  be  washed  with  warm  water,  and  afterwards  to  be 
powdered  with  common  hair  powder,  or  with  fuller's  earth,  or  with  the 
seeds  of  the  Iycopodium.  It  is  likewise  of  use  to  anoint  them  with  any 
soft  ointment. 


552  PEDIATRICS  OF  THE  PAST 

CHAPTER  53 

OF  CHILBLAINS 

Chilblains  arise  in  the  winter  season,  and  affect  the  fingers,  or  toes, 
or  the  heel  and  edges  of  the  feet.  They  produce  redness  and  slight  inflam- 
mation, and  sometimes  also  ulceration.  The  pain  is  inconsiderable,  but 
there  is  great  itching.  These  complaints  as  they  are  originally  brought 
on  by  cold,  so  they  ought  in  the  first  place  to  be  defended  from  it.  Many 
rub  the  affected  parts  with  the  camphorated  spirit,  or  with  the  Iinamen- 
tum  saponis:  others,  more  properly  in  my  opinion,  cover  them  with  some 
cerate  spread  upon  linen,  or  upon  thin  leather,  as  the  ceratum  Iapidis 
calaminaris,  the  ceratum  saponis,  or  the  emplastrum  Iithargyri:  and 
these  may  be  employed  even  after  the  skin  is  broken,  and  an  ulcer  is 
formed.  Sometimes  it  becomes  necessary  to  apply  a  poultice.  Whether  the 
parts  are  ulcerated  or  not,  electricity  is  said  to  have  been  beneficial. 

CHAPTER  54 
OF  THE  SCALD-HEAD 

The  scald-head  is  a  disease  of  the  head,  in  which  a  scurf  and  sort  of 
small  scales  are  formed  upon  the  scalp,  with  itching  and  falling  off  of  the 
hair.  And  this  takes  place  sometimes  with,  sometimes  without  ulceration. 
Sometimes  also  it  spreads  further,  till  the  whole  head  is  covered  with  a 
foul  tetter.  It  is  a  contagious  disease,  and  easily  communicated  among 
children,  who  use  the  same  combs,  or  the  same  pillows,  or  the  same  hats. 

The  following  external  applications  are  proper  against  this  complaint: 
the  unguentum  hydrargyri  nitrati,  the  unguentum  calcis  hydrargyrus 
muriatus  in  water,  or  a  decoction  of  the  white  hellebore,  or  of  tobacco, 
and  almost  any  acrid  substances.  These  sometimes  speedily  extinguish 
the  scald-head  in  its  early  stage.  More  commonly  it  continues  for  two 
months,  or  longer;  in  which  case  the  head  should  be  shaved,  and  washed 
with  soap  and  water,  or  with  water  in  which  an  alkaline  salt  has  been  dis- 
solved; and  afterwards  anointed  with  some  one  of  the  applications  men- 
tioned above,  or  with  the  unguentum  picis.  These  must  be  continued  till 
all  remains  of  the  disease  are  gone,  and  the  new  hair  springs  up.  There'  is 
little  advantage  to  be  derived  from  medicines  taken  internally. 

CHAPTER  35 

OF  THE  SCROFULA 

The  scrofula  is  when  the  lymphatic  glands  swell,  or  sometimes  inflame 
and  suppurate;  which  may  take  place  in  other  parts,  but  is  most  frequent 
in  the  neck.  In  children  likewise  the  glands  of  the  mesentary  are  subject 


THE  HERBERDENS  553 

to  the  same  disease;  in  consequence  of  which  the  belly  swells,  whilst  the 
rest  of  the  body  wastes  away. 

The  scrofula  most  commonly  shows  itself  between  the  second  and  the 
twelfth  year;  sometimes  later.  And  it  particularly  attacks  those  who  are 
born  of  scrofulous  parents,  and  whose  constitution  is  infirm,  whose  com- 
plexion fair,  whose  nostrils  and  lips  are  tumid,  and  whose  eyelids  are 
subject  to  frequent  inflammations. 

There  is  another,  and  more  severe  species  of  this  disorder,  which 
affects  the  fingers  and  limbs,  in  which  it  occasions  swellings  and  ulcer- 
ation, or  which  it  even  quite  corrodes. 

In  some  we  perceive  the  glands  in  the  neck  to  swell  from  a  very  slight, 
or  no  manifest  cause,  and  again  totally  subside  after  a  week,  or  perhaps 
a  month,  or  longer.  I  am  doubtful  whether  this  has  any  relation  to  the 
scrofula;  as  it  more  readily  yields  to  purgative  medicines,  and  is  often 
unattended  through  the  rest  of  life  with  any  other  indications  of  a 
scrofulous  habit. 

Where  the  disorder  is  more  deeply  fixed,  the  patient  should  remove  to 
the  sea  side,  and  also  bathe  in  the  sea,  provided  he  has  no  fever.  At  the 
same  time  some  have  appeared  to  derive  advantage  from  drinking  the 
sea  water  so  as  to  move  the  body  every  third  or  fourth  day  for  several 
weeks.  In  almost  all,  the  Peruvian  bark  is  useful,  either  in  some  simple 
preparation,  or  in  combination  with  the  natron  praeparatum. 

The  properest  drink  is  the  Malvern  water,  or  distilled  water.  The  food 
also  ought  to  consist  of  the  lightest  materials,  which  may  nourish  the 
body,  without  exasperating  the  disease. 

CHAPTER  56 
OF  A  WHITE-SWELLING 

To  the  class  of  scrofulous  complaints  likewise  belongs  that  disorder, 
which  is  called  a  white  swelling;  in  which  the  knee  is  for  a  long  time 
swelled  and  painful,  and  at  length  the  bones  themselves  are  corroded. 
To  these  are  joined  a  hectic  fever,  and  universal  decline. 

When  the  disease  is  recent,  its  remedies  are  nearly  the  same  as  for 
the  scrofula.  In  addition  to  which  it  is  proper  to  excite  ulceration  exter- 
nally near  the  joint,  and  to  keep  up  the  discharge  a  long  time.  Frequently 
however  an  amputation  of  the  limb  becomes  necessary. 

CHAPTER  57 
OF  THE  DISEASED  HIP 

Another  disease  of  the  same  kind  arises  in  the  hip,  where  it  occasions 
suppuration,  which  by  degrees  destroys  the  whole  joint.  In  these  cases 


554  PEDIATRICS  OF  THE  PAST 

the  knee  is  in  more  pain  than  the  hip:  and  generally  the  leg  of  that  side 
becomes  longer  than  the  other;  but  the  thigh  wastes,  and  is  unable  to 
support  the  weight  of  the  body.  The  patient  in  the  mean  time  is 
emaciated,  and  pines  away  with  a  slow  fever.  There  are  some  who  linger 
on  for  three  years  before  they  die.  Very  few  recover,  and  these  always 
continue  lame.  Sometimes  death  anticipates  the  discharge  of  the  collected 
matter;  more  commonly  an  open  sore  is  at  length  produced,  which 
rapidly  precipitates  the  sinking  patient. 

To  persons  thus  affected,  the  Peruvian  bark  should  be  administered ; 
and  with  this,  two  or  more  large  issues  ought  to  be  made  round  the  joint. 
The  strength  is  by  all  means  to  be  supported;  and  if  at  any  time  any 
thing  should  be  discovered  to  be  useful  against  the  scrofula,  it  might  be 
hoped  that  it  would  afford  likewise  the  best  remedy  for  this  disease. 

CHAPTER  58 
OF  THE  CURVED  SPINE 

Another  disease  allied  to  the  preceding,  though  it  may  happen  at 
any  age,  yet  is  chiefly  met  with  in  childhood.  In  this  the  anterior  parts  of 
the  vertebrae  are  affected  with  ulceration  and  pain,  to  which  are  added 
convulsive  spasms  and  palsy  of  the  lower  limbs;  afterwards,  when  the 
bodies  of  the  vertebrae  are  destroyed,  the  spine  falls  in  and  is  bent  for- 
wards, and  one  or  more  of  the  bones  project  behind. 

The  only  remedy  is  to  make  two  deep  issues  in  the  back  on  each  side 
of  the  diseased  part,  and  to  keep  them  open  till  the  patient  is  recovered. 
There  will  be  no  harm  however  in  making  him  take  at  the  same  time  some 
Peruvian  bark.  Besides  this,  some  recommend  a  neck-swing,  or  other 
support  for  the  head,  that  the  body  may  become  more  erect,  and  the 
deformity  lessened. 

CHAPTER  59 
OF  THE  RICKETS 

In  the  seventeenth  century  the  rickets  appears  to  have  been  very 
common  all  over  Europe,  but  particularly  in  England.  However  this 
may  be,  in  our  own  times  at  least  it  is  become  much  more  rare.  The  usual 
time  of  its  occurrence  is' in  children  under  three  years  of  age.  In  these 
the  flesh  loses  its  firmness,  the  joints  and  the  belly  swell,  the  bones  are 
curved,  the  teeth  decay,  and  an  universal  weakness  takes  place. 

To  counteract  these  effects,  the  body  must  be  supported  by  whole- 
some nourishment,  and  suitable  exercise;  and  frictions,  and  country  air, 
and  cold  bathing,  and  the  Peruvian  bark  should  be  employed. 


THE  HERBERDENS  535 

CHAPTER  60 

OF  THE  CLEFT-SPINE 

The  spina  bifida,  or  cleft-spine,  is  distinguished  by  a  soft  tumor  on 
some  part  of  the  back  bone,  chiefly  about  the  loins.  For  the  spinal  process 
of  one  or  more  of  the  vertebrae  is  either  entirely  wanting,  or  is  divided; 
and  the  membrane  which  contains  the  spinal  marrow  is  distended  with 
a  fluid,  and  projects  outwards.  When  this  bursts,  there  succeeds  an 
inflammation  of  the  spinal  marrow,  which  is  speedily  fatal.  Children, 
who  are  the  subjects  of  this  disorder,  rarely  survive  fifteen  months. 

It  may  be  made  a  question,  whether  by  constant  and  gentle  pressure 
it  is  conceivable  that  this  fluid  may  be  absorbed?  Also  whether  it  be 
admissible  by  a  small  oblique  wound  to  draw  off  the  collected  humour? 
(In  the  Accounts  published  by  the  Royal  Society  of  Medicine  at  Paris, 
for  the  year  1784,  (p.  66) ,  is  given  the  history  of  a  young  man  in  his 
twenty-eighth  year,  who  was  born  with  a  swelling  of  this  kind  upon  his 
loins.  In  his  twelfth  year,  when  it  was  become  of  a  large  size,  a  surgeon 
opened  it,  and  let  out  all  the  inclosed  fluid;  nor  was  this  followed  by 
death,  but  by  great  debility;  and  the  tumor  soon  grew  up  again.  At 
length  in  his  twentieth  year,  when  it  had  increased  to  the  size  of  a  child's 
head,  he  accidentally  lay  upon  it,  in  consequence  of  which  inflammation 
and  mortification  came  on,  and  he  was  brought  into  the  most  imminent 
danger  of  his  life:  but  beyond  all  expectation,  at  that  very  time  the 
humour  was  absorbed,  and  a  cicatrix  was  formed  on  the  collapsed  skin, 
and  the  patient,  though  very  weak,  yet  survived.) 

CHAPTER  61 

OF  THE  HARE-LIP  " 

Children  are  sometimes  born  with  the  upper  lip  divided,  which 
deformity  can  only  be  removed  by  an  operation.  The  time  for  performing 
this  is  to  be  chosen  either  so  soon  after  the  birth  that  scarcely  any  food 
is  required,  or  so  late  that  the  child  can  conveniently  be  fed  by  the  hand. 
The  lip  therefore  ought  to  be  cut  either  on  the  very  day  of  his  birth; 
or,  which  I  should  consider  as  safer,  not  till  after  he  has  completed  his 
fourth  month.  In  some  the  palate  is  affected  at  the  same  time;  from  which 
cause  the  voice  is  inarticulate,  and  fluids,  as  they  are  swallowed,  are 
apt  to  return  through  the  nose. 

-     The  End 


FRIEDRICH  LUDWIG  MEISSNER 

[1796- 1 860] 

ONE  of  the  most  important  contributions  to  the  bibliography 
of  pediatrics  is  entitled  "Grundlage  der  Literatur  der  Padia- 
trik,  enthaltend  die  Monographien  iiber  die  Kinderkrank- 
heiten."  It  is  one  of  the  numerous  contributions  of  an  indefatiga- 
ble worker,  Friedrich  Ludwig  Meissner,  a  Saxon  who  first  saw  the 
light  of  day  in  Leipsic  in  1796.  The  same  pleasant  University 
town  was  the  scene  of  his  studies  and  of  his  subsequent  labors. 
Only  when  disease  assailed  him,  in  1857,  did  he  remove  to  Dresden 
where  he  died  of  apoplexy  in  i860. 

Meissner  got  his  doctorate  in  18 19,  but  later  he  established 
himself  as  an  obstetrician  and  gynecologist,  to  which  combination 
he  added,  as  was  the  fashion  of  the  day,  pediatrics.  He  was  a 
successful  practitioner,  an  able  writer  and  did  much  to  encourage 
medical  science,  particularly  in  his  own  specialties.  In  1838  he 
was  instrumental  in  establishing  a  policlinic  for  obstetrics  and 
later  took  an  interest  in  the  welfare  of  the  deaf  and  dumb. 

In  1826,  he  published  his  "Forschungen  des  19  Jahrhundert 
im  Gebiet  der  Geburtshelfe;  Frauenzimmer  und  Kinder  krank- 
heiten."  Two  years  later  his  work  on  children  appeared  with  the 
title  "Die  Kinderkrankheiten  nach  den  neuesten  Ansichten  und 
Erfahrungen."  This  was  a  successful  publication  which  went  into 
the  third  edition  in  1845.  These  are  only  a  few  of  his  works.  There 
were  many  others,  mostly  of  a  technical  nature,  and  certain 
popular  medical  articles  of  his  were  signed  by  three  different 
noms  de  plume.  In  1853,  in  connection  with  Opitz,  he  issued  a 
book  for  parents,  called  "Der  Lehrer  und  der  Arzt  als  Rathgeber 
fur  Eltern  bei  Erziehung  ihrer  Kinder." 

The  "Grundlage,"  the  first  part  of  which  dealing  with  earlier 
publications,  is  here  reprinted,  is  a  splendid  list  of  early  pediatric 
writings.  A  valuable  work  of  reference,  unfortunately  not  quite 
complete,  but  no  work  of  this  kind  could  be.  With  Meissner's 
list  in  hand,  one  may  plan  a  journey  into  the  history  of  pediatrics, 

556 


D  i  e 

Kinderkrankheiten 

nach  den 

neuesten  Ansichten  and  Erfahnmgen 

hi 

Unterricht  fur  practische  Aerzte 

bearbeitei 

ton 

Friedrich  Ludwig  Meissner, 

Doctor  der  Median,  Chirargie  and  GeburtshiiLfe,  academitchen  Privat-Do* 
cetden,  der  medirinfechen ,  der  natarfonchenden  Gesellschaft  and  der  Ocono* 
miochen  Societit  zu  Leipzig  ordeotlichem ,  der  KaijerL  finja.  Akademie  »u 
Kctkau,  ao  wie  der  Academic  royale  *a  Parif  eorreflpondirtodem  und  det 
Apothekervereint  im  nSrdliclien  Deufscbland  Khren  -  Mitgliede. 


Zweite  gant  urogcarheitetc   und  »ehr  vermehrtc  Auflage. 


Enter  Theil. 


Leipzig, 

Fcst'iclic    V.c  r  1  a  g  k  b  u c*  h  kt  n d I  u  u  £. 

183  8. 

Title  page  of  Meissner's  book  on  the  diseases  of  children. 


558  PEDIATRICS  OF  THE  PAST 

if  he  is  fortunate  enough  to  have  access  to  all  the  interesting 
items.  The  library  of  the  Surgeon  General's  Office  is  the  only 
place  in  America  where  anything  like  an  adequate  number  will 
be  found. 


SCHRIFTEN  UBER  KINDERKRANKHEITEN  IM  ALLGEMEINEN 

Paul,  de  Flumine  Bagellardes,  De  aegritudinibus  et  remediis  infantum. 

1472.  4.  Haller  Bibl.  Med.  Pr.  1.  p.  466. 
Abubeker  (Zachariae  filii)  Libellus  de  morbis  puerorum.  Ludg.  15 10. 
Barth.  Merlinger,  De  valitudine  infantum  tuenda,  curandis  morbis. 

Francof.  1531. 
[This  misspelling  of  Metlinger's  name  was  a  misprint  in  this  Edition. 

See  Metlinger.] 
Mich.  Angel.  Blondus,  De  adfectionibus  infantum  et  puerorum.  Venetiis 

1537.  8. 
Petr.  Jac.  Toletus,  De  morbis  puerorum.  Lugdun,  1538. 
Pauli  Cornelii,  Tractatus  de  peurorum  infantumque  morborum  digno- 

tione  et  curatione.  Basil.  1540. 
Sebast.  Austrius,  De  Puerorum  morbis.  Basil.  1549.  8. 
Hier.  Montaus,  De  infantum  febribus.  Lyon  1550. 
Lud.  Lobera  de  Avila,  De  diaeta — ut  et  morbis  infantum,  Pincia,  1551. 
Marc.  Mironius,  De  infantibus.  Turon  1553. 
Leonelli,  De  aegritudinibus  infantum.  Venet.  1557. 
Joh.  Kueffner,  De  morbis  puerorum.  Venet.  1557.  8. 
Bald.  Russeus,  De  hominis  primordiis  et  infantilibus  aliquot  morbis. 

Lovann.  1559.  8. 
Euchar.  Rhodion,  De  partu  hominis, — de  parturientium  et  infantum 

morbis  atque  cura.  Francof.  1563.  8. 
Lion.    Faventinus    de   Victoriis,    De    aegritudinibus    infantum.    Cum 

appendice  Kueffneri.  Lugd.  1574.  8.  (Ingolstad.  1644.  8.) 
Omnibonus  Ferrarius,  De  arte  medica  infantum  Iibri  iv.  Brixiae  1577. 

4.  (Lipsiae  1705). 
Hier.  Mercurialis,  De  morbis  puerorum  Tractatus.  Venet.  1583.  (Basil. 

1584.  8.) 
Jac.  Trunconius,  De  custotienda  puerorum  sanitate.  Florent.  1594. 
Marius  Zuccarius,  De  morbis  puerorum,  Napoli  1604.  4. 
Joh.  Ceckius,  Dissert,  inaug.  de  puerorum  tuenda  valetudine.  Viteberg. 

1604.  8. 
Tractatus  duo  de  morbis  pueror.  patholog.  Lips.  1605.  (Amstelod.  1760.) 
Cregut,  Dissert,  de  aegritudinibus  infantum  ac  puerorum.  Basil.  1606. 
Jo  Hucher,  De  diaeta  et  therapia  puerorum.  Colon.  1610. 
Perdulcis,  Non  ergo  sola  puerorum  morbis  medetur  natura.  Paris.  1610. 


Friedrich  Ludwig  Meissner 
[1796- i 860] 


Grandlage  der  Llterator 


der 


Padiatrik, 


entbaltend 


die  looographien  fiber  die  Kmderkrankheiten 


van 


&rt^rtc/£   SZitc/tcva    vd&e&ikfnex. 

Doctor  der  Medicln,  Chinirgle  and  Gebnrtshtllfe,  akademlscbem  Prirat-Doeentett,  dor 
sehtn,  der  natorforacbenden  GeaeUacbaft  and  der  tfkonomlacben  Societitt  an  Leipzig  ordentUehom, 
der  Kalaerl.  Base.  Akademle  sa  Moskaa,  der  Acadt'mio  royale  zu  Paris,  der  KaleerL  KonlffL 
GeeeOecbaft  der  Aerzte  zn  Wien,  der  medidniechen  GeeeDeebaft  an  Antwerpen,  der  GeeettecbafV 
fUrKatarwiesenecnaiten  zuBrtiggc,  der  medicmlscben  GeeeBschaft  an  Gent,  der  QoeoBsfbafUm  fttr 
Natanrfaaenachaften  and  Heflkande  zu  Heidelberg  and  BrBseel,  dee  Irstliehen  Verelne  m  Hem- 
barf,  der  medlcmlschen  GeeeUecbeit  *u  Rotterdam  correspondirendem,  dee  Apothekerrereina 
1m  oBrdUcnen  Dentecbland  and  der  medleiiileeb-cbirarglechen  Socletit  sa  Bragf* 
EhrenmltgHede. 


Mseipcig, 

Ferfscbe  Verlagsbuchhandlung. 
1850. 

Title  page  of  Meissner's  "Grundlage.' 


56o  PEDIATRICS  OF  THE  PAST 

Franc.  Perez.  Cascalis,  De  puerorum  affectibus.  Madrit.  1611.  4. 
Zuihlius,  Dissert,  de  quibusdam  peurorum  affectibus.  Basil.  161 3. 
Strobelberger,  Manuduct.  de  curandis  pueril.  affectibus.  Lips.  1629.  8. 
Amthor,  Nosocomium  infantile  et  puerile.  Schleussing.  1638. 
Nicol.  Fontanus,  Commentarius  in  Sebast.  Austrii  opus  de  puerorum 

morbis.  Amstelod.  1642.  8. 
Sebiz,  Dissert,  de  infantum  et  peurorum  morbis.  Argentorati  1649. 
Jac.  Primrosius,  de  morbis  puerorum  Iibri  duo.  Roterod.  1658.  12. 
Phil.  Grilling,  Tractat  von  Kinderkrankheiten.  Nordhausen  1660.  4. 
Welsch,  Dissert,  inaug.  de  nutritione  infantis  ad  vitam  Iongam  Helmonti- 

ana  et  morbis  infantum.  Lips.  1667. 
Bouvier,  Dissert,  de  nonnullis  infantum  adfectibus.  Leidae  1670. 
Ettmueller,  Valetudinarium  infantile.  Lips.  1675.  4- 
Chr.  Lamperti,  Erwunschter  Hausarzt  der  kranken  kindheit.  Merseburg 

1689.  8. 
Hier.  Sorianus,  Experimenta  medica  facilia  et  vera  methodus  curandi 

morbos  infantum.  Saragossae  1690.  8. 
Jo.  Pechey,  On  the  diseases  of  infants  and  children.  London,  1697. 
Jo.  Fr.  Loew,  Apodixis  de  morbis  infantum.  Norimberg  1699.  4. 
Ph.  Jac.  Duettel  (Praes.  Fr.  Hoffmann),  de  morbis  foetuum  in  utero 

materno.  Halae  1702.  4. 
J.   Christ.   Schroeck,   Unterricht   von   junger,   unerwachsener   Kinder 

Krankheiten.  Berlin  1704.  8. 
Valentini,  De  morbis  infantum  liber.  Giess.  1704. 

J.  Christ.  Tabor,  Unterricht  von  allerhand  Krankheiten  junger  uner- 
wachsener Kinder.  Berlin  1704.  8. 
Stahl,  Dissert,  inaug.  de  infantum  affectibus.  Halae  1 705. 
C.  D.  Bartenstein,  De  morb.  infant,  recens  natorum.  Argentorati  171 1.  4. 
Ladeging,  Dissert,  de  morbis  infantum  acutis.  Groning  1713. 
Fr.  Hoffmann,  Praxis  clinica  morborum  infantum.  Halae  1715.  4. 
Th.  Harris,  De  morbis  acutis  infantum.  Amstelod.  1715.  8.  (Lugd.  171 8.) 
J.  Goldhammer,  Compendieuser  Weiber-u.  Kinderarzt.  Muhlheim  1717. 

12. 
v.  Wedel,  De  morbis  infantum.  Jenae  17 17. 
Th.  Zwinger,  Paedojatria  practica.  Basil.  1722.  8. 
Franc,  de  Franckenau,  De  morbis  infantum  Hippocratis.  Hafniae  1725. 
Friis,  Dissert,  de  infantum  morbis.  Hafniae  1725. 

Jameson,  Dissert,  de  morbis  infantum  ab  infantia  ortis.  Edinburgh  1731- 
Casp.  Amthor,  Kinderlazareth.  Schleussingen  1738.  8. 
Wolff,  Dissert,  inaug.  de  causis,  cur  frequentius  aegrotent  infantes 

Iautioris,  quam  pauperioris  conditionis.  Altdorfi  1738. 
Val.  Kraeutermann,  Getreuer,  sorgfaltiger  und  geschwinder  Kinderarzt. 

Frankfurt  und  Leipzig  1740.  8.  (2.  Aufl.  1793.) 


FRIEDRICH  LUDWIG  MEISSNER  561 

Fr.  Hoffmann,  Vernunftige  und  grundliche  Abhandlung  von  den  fiihr- 
nehmsten  Kfnderkrankheiten.  Nunmehro  mit  dessen  Lebenslauf 
versehen  von  Dr.  Joh.  Heinr.  Schulzen  Frankfurt  und  Leipzig. 

1741. 
Juncker,  Dissert,  inaug.  de  morbis  infantum.  Halae  1746. 
Fr.  Hoffmann,  de  praecipuis  infantum  morbis.  Halae  1747.  8. 
C.  A.  de  Bergen,  Aphorismi  de  cognoscendis  et  curandis  infantum  morbis. 

Francofurti  1750.  4. 
J.   Storch    (alias   Pelargi),   Theoretische   und  practische  Abhandlung 

von  den  Kinderkrankheiten.  4  Bande.  Eisenach  1 750-1 757.  8. 
Nic.    Borner,    Kinderarzt,    oder    Unterricht    von    Kinderkrankheiten 

u.  s.  w.  Frankfurt  u.  Leipzig  1752.  8. 
Rosen,  Dissert,  de  morbis  infantum.  Upsal.  1752. 
Ludw.  Wilh.  Knoer,  Der  bei  Kinderkrankheiten  vernunstig  curirende 

Medicus.  Leipzig  1753.  8. 
Brouzet,  Essai  sur  Teducation  medicale  des  enfans  et  sur  Ieurs  maladies. 

Paris  1754.  12.  11  Vol. 
Juckner,  Dissert,  de  quatuor  praecipuis  infantum  morbis  compendiaria 

ac  felici  methodo  curandis.  Halae  1758. 
Mr.  Paul,  Traite  des  maladies  des  enfans.  Avignon  1759.  8. 
J.  S.  J.  Schulze,  De  morbis  infantum  ex  matrum  indulg.  Gotting.  1759.  4. 
Tractatus  duo  pathologici:  De  morbis  puerorum  et  de  morbis  cutaneis. 

Amstelodami  1760.  8. 
Ant.   Fracussini,  Opuscula  pathologica.   Dissert,  exhibens  affectiones 

infantiae  et  pueritiae.  Veronae  1763.  4. 
Brouzet,  Abhandlung  von  der  medicinischen  Erziehung  der  Kinder  und 

den  Krankheiten  derselben.  Aus  dem  Franz,  v.  J.  S.  Bisten.  Alten- 

burg,  1764.  8.  2  Thle. 
Nils  Rosen  v.  Rosenstein,  Underrattelser  om  Barn-Sjukdomar  och  deras 

Bote  Medel.  Stockholm  1764.  8.  (in  Edit.  1771.) 
Tergestini,  Dissert,  inaug.  de  morbis  infantum.  Vienn.  1767. 
Vogel,  Dissert,  de  nonnullis  parentum  deliciis  in  morbos  infantum  pler- 

umque  degenerantibus.  Goetting.  1 767. 
Armstrong,  Essay  on  the  diseases  most  fatal  to  infants.  London.  1768.  8. 

(hi  Edit.  1771.) 
Herm.  Boerhaave,  Maladies  des  femmes  et  des  enfans.  Paris,  1768.  12. 
Raulin,  De  la  conservation  des  enfans.  Paris  1769. 
G.    Armstrong's   Versuch    von    den    vorzunlichsten    u.    gefahrlichsten 

Kinderkrankheiten,  nebst  Regeln,  welche  man  beim  Saugen  der 

Kinder,  wie  auch  bei  solchen  beobachten  muss,  die  ohne  Brust 

aufgezogen    werden.    Aus   dem    Engl.    Zelle    1769.    8.  (Uebers.  v. 

Schaffer.  Regensb.  1786.  2.  Aufl.  1792.) 
J.  Croke,  Des  maladies  des  enfans.  Yverdon  1770.  8. 
Rogerson,  Dissert,  de  morbis  infantum.  Edinb.  1770. 


562  PEDIATRICS  OF  THE  PAST 

Deleurye,  La  mere  selon  1'ordre  de  la  nature,  avec  un  Traite  sur  Ies 
maladies  des  enfans.  Paris  1772.  12. — In  deutscher  Sprache,  Frank- 
furt und  Leipzig  1774.  8. 

A  Treatise  on  the  diseases  of  infants  and  children.  London  1772.  8. 

C.  J.  Oehme,  Diss,  de  morbis  recens  natorum  chirurgicis.  Lips.  1773. 4- 

G.  Armstrong.  Account  of  the  diseases- most  incident  to  children  from 
their  birth  till  the  age  of  puberty,  etc.  London  1777.  8.  Ill  Edit. 

Guenet,  Instruction  abregee  sur  Ies  maladies  des  enfans.  Paris  1777.  12. 

Raulin,  Traite  des  maladies  des  enfans.  Paris  1779.  8. 

Rud.  Aug.  Vogel,  Kenntniss  und  Heilung  der  vornehmsten  Kinderkrank- 
heiten.  Leipzig  1780.  8. 

W.  Moss,  Essay  on  the  management  and  nursing  of  children  in  the 
earlier  periods  of  infancy.  London  1 78 1 . 

Jos.  Vz.  Pfab,  Dissert,  inaug.  sistens  morbos  infantum.  Vienn.  1782.  8. 

F.  Jos.  Dimler,  Dissert,  inaug.  difficultates  in  curatione  morborum 
infantilium  obvenientes  succincte  exponens.  Gotting.  1782.  4. 

J.  Vet.  H.  Siegel,  Dissert,  inaug.  de  cura  neonatorum  medica.  Gotting. 
1782.  4. 

Mich.  Underwood,  A  treatise  on  the  diseases  of  children,  with  directions 
for  the  management  of  infants  from  the  birth.  London  1784.  8.  (in 
Edit.  1795.  11  Vol.) 

C.  J.  Mellin,  Der  Kinderarzt.  Kempten  1787.  8.  (3.  Aufl.  bearb.  von  J. 
G.  Hertel  1829.  8.) 

Der  sorgfaltige  Kinderarzt.  Ein  medicinisches  Handbuch  f.  Aerzte  und 
Nichtarzte.  Leipzig  1786.  8. 

Der  englische  Kinderarzt,  nach  den  Grundsatzen  von  Moss  und  Under- 
wood. Leipzig  1786.  8. 

Recepte  fur  Kinderkrankheiten  u.  venerische  Krankheiten.  Leipzig 
1791.8. 

(J.  G.  Frz.  v.  P.  Ahorner  v.  Ahornrein)  Bibliothek  fur  Kinderarzte. 
Wien  1792.  8.  2  Bandchen. 

Hopfengartner,  iiber  die  menschlichen  Entwickelungen  und  die  mit 
denselben  in  Verbindung  stehenden  Krankheiten.  Stuttgart  1792.  8. 

Alex.  Hamilton,  Treatise  on  the  management  of  female  complaints  and 
of  children  in  early  infancy.  Edinburgh  1792.  8. 

Sammlung  interessanter  Abhandlung  uber  etliche  wichtige  Kinder- 
krankheiten. Liegnitz  1793.  8. 

Untersuchung  derjenigen  Krankheiten  neugeborner  Kinder,  welche  eine 
chirugische  Behandlung  erfordern,  und  der  dabei  anwendbaren 
Arzneimittel  und  Operationen.  Chemnitz  1794.  8. 

Ghr.  Girtanner,  Abhandlung  iiber  die  Krankheiten  der  Kinder  und  uber 
die  physische  Erziehung  derselben.  Berlin  1794.  8. 

J.  Clough,  Observations  on  Pregnancy,  and  the  diseases  of  children. 
London  1796.  8. 


FRIEDRICH  LUDWIG  MEISSNER  563 

C.  A.  Struve,  Neues  Handbuch  der  Kinderkrankheiten.  Breslau  1797.  8. 

Nil.  Rosen  v.  Rosenstein,  Anweisung  zur  Kenntniss  und  Cur  der  Kinder- 
krankheiten. Aus  dem  Schwed.  6.  Aufl.  mit  Ammerkgn.  von  Loder 
u.  Buchholz.  Gottingen  1798.  8. 

Ch.  W.  Hufeland,  Bemerkungen  iiber  die  naturlichen  und  inoculirten 
Blattern,  verschiedene  Kinderkrankheiten  u.  s.  w.  3.  Aufl.  Berlin 
1798.  8. 

Wagner  (Praes.  Boehmer),  Dissert,  de  morbis,  a  nutricibus  aliisque 
foeminis,  quae  infantum  curam  gerunt.  ad  hos  translatis.  Viteberg 

1798. 
Jo.  Georg.  Breiting,  Diss,  inaug.  sistens  Morborum  quorundam  rariorum 

in  neonatis  occurentium  descriptionem.  Jenae  1799. 4. 
Autenrieth,   Dissert,    sistens  Observationes   physiologico-pathologicas, 

quae  neonatorum  morbos  frequentiores  spectant.  Tubing.  1799. 
J.  H.  John  (praes.  Autenrieth),  Observationes  quaedan  quae  neona- 
torum morbos  frequentiores  spectant.  Tubing.  1799.  4- 
Baigneres  et  Perrol,  Traite  des  maladies  des  femmes  enceintes,  des 

femmes  en  couche  et  des  enfans  nouveaux-nes.  Paris  an  vn. 
N.  Chambon  de  Montaux,  Des  maladies  des  enfans.  Tom.  11.  an  vn.  8. 
Will  Nisbett,   The   clinical  guide,   or  a  concise  view  of  the  leading 

Facts  on  the  history,  nature  and  treatment  of  the  state  and  diseases 

of  infancy  and  childhood.  London  1800.  12. 


AN  ADDITIONAL  BIBLIOGRAPHY  OF  PEDIATRIC 

LITERATURE 

IN  addition  to  the  Meissner  list  the  following  is  submitted  as  a  partial 
bibliography  up  to  1800.  There  are  one  or  two  repetitions,  the  reasons 
for  which  are  apparent.  This  list  is  by  no  means  complete.  The 
author  has  in  preparation  what  he  hopes  will  be  a  definitive  bibliography 
of  pediatrics  through  the  year  1800.  The  list  is  arranged  alphabetically 
by  authors. 

Alexandrinus,  J.,  Paedotrophia,  sive  de  puerorum  educatione  liber.  120. 
Tiguri,  1559. 

de  Almeida,  F.  J.,  Tratado  da  educacao  fysica  dos  meninos,  para  uso  da 
nacao  portugueza,  publicado  por  ordem  da  Academia  real  das 
sciencias.    8°.    Lisboa,    1791- 

Amiet,  F.  U.,  *Essai  sur  Ies  differences  constantes  et  accidentelles, 
resultantes  de  Porganisation  et  de  F  education,  considerees  sous  Ie 
rapport  de  sante  et  de  maladie,  depuis  la  naissance  jusqu'a  la 
puberte.  8°.  Paris,  an  vn  [1799]- 

Amthor,  C,  Nosocomium  infantile,  et  puerile:  Das  ist,  Kinder-Lazaret, 
darinnen  die  vornembsten  Anstosse  der  jungen  Kinder  erzehlet,  und 
wie  man  solchen  mit  Gottes  Hiilffe  begegnen  konne,  schone, 
gewisse  und  sichere  Experimenta  eingefuhret  werden,  alien  Hauss- 
muttern,  welche  nicht  alsobald  eines  Medici  habhafft  werden 
konnen,  sehr  nutzlich  und  trostlich.  120.  Schleusingen,  1638. 

Appeal  (An)  to  humanity,  in  an  account  of  the  life  and  cruel  actions  of 
Elizabeth  Brownrigg,  who  was  tried  at  the  Old  Bailey  on  the  12th 
of  September  1767,  and  sentenced  to  be  hanged  at  Tyburn  on 
Monday  the  14th  of  the  same  month,  for  cruelly  beating  and 
starving  Mary  Clifford,  a  parish  girl,  her  apprentice,  giving  a  true 
and  circumstantial  account  of  that  barbarous  transaction.  To  which 
is  added  the  trial  of  Elizabeth  Branch  and  her  daughter  for  the 
murder  of  their  servant  maid,  etc.  8°.  London,  1767. 

Archiv  fur  die  Geburtshulfe,  Frauenzimmer  und  neugebohrner 
Kinder-Krankheiten.  Hrsg.  von  Johann  Christ.  Stark.  Bde.  1-6 
(a  4  Stucke),  1787-96,  6V.  8°.  Jena. 

Armstrong,  George.  An  essay  on  the  diseases  most  fatal  to  infants.  To 
which  are  added  rules  to  be  observed  in  the  nursing  of  children; 
with  a  particular  view  to  those  who  are  brought  up  by  hand.  12°. 
London,  1767. 

564 


ADDITIONAL  PEDIATRIC  BIBLIOGRAPHY       565 

2  ed.  with  additions.  160.  London,  1771, 

An  account  of  the  diseases  most  incident  to  children  from  their  birth 

till  the  age  of  puberty.  8°.  London,  1777. 
Ibid,  1783. 
Art   (The)   of  nursing:  or,  the  method  of  bringing  up  young  children 

according  to  the  rules  of  physick,  for  the  preservation  of  health, 

and  prolonging  life.  2  ed.,  to  which  is  prefixed,  an  arcutio,  with  its 

dimensions,  used  abroad  to  prevent  the  overlaying  of  children. 

120.  London,  1733. 
Artz    (De)    der   moeders;   in   aangenaame   spectatoriaale   vertoogen, 

op  eene  klaare  en  eenvoudige  wyze  Ieerende,  wat  men  moet  doen  om 

het  gestel  van  jonge  kinderen  voor  te  bereiden  tot  een  gezond, 

Iang,  en  gelukkig  Ieeven.  8°.  te  Amsterdam,  1771. 
Astruc,  J.,  A  general  and  complete  treatise  on  all  the  diseases  incident 

to  children,  from  their  birth  to  the  age  of  fifteen.  8°.  London,  1746. 
Austrius,   Sebastianus.   De   infantium   sive  puerorum,   morborum,   et 

symptomatum,   diagnotione,   turn  curatione  liber.    120.   Basileae, 

1540. 
De  puerorum  morbis,  et  symptomatis  turn  diagnoscendis  turn  curandis 

liber.   Ex  Graecorum,  Latinorum  et  Arabum  placitis  excerptus. 

Adjecti  sunt  Hippoc.  Aph.  aliquot  de  noviter  natorum  adfectibus, 

alii  item  aphoristici  sensus  ex  variis  authoribus  de  eorundem  bona 

valetudine  tuenda.  240.  Lugdini,  1549. 
Baggelardus  a  Flumine,  P.,  Libellus  de  egritudini  infantum.  Padua,  1472. 
Libretto  singular  de  tutte  la  malatie  dal  nascimento  fina  anni  siete 

per  miastro  Paulo  Balgiebardo.  [n.p.]  i486. 
Libellus  de  aegritudinibus  infantium.   Finit  perbreve  opusculum  de 

infantium  infirmitatibus  remediisque  earum.  40.  [Paduae],  1487. 
(See  Toletus.) 
Ballexserd,  J.,  Diss,  sur  Teducation  physique  des  enfans,  depuis  Ieur 

naissance  jusqu'a  Tage  de  puberte.  8°.  Paris,  1762. 
Bard,  S.,  An  enquiry  into  the  nature,  cause,  and  cure,  of  the  angina  suffo- 

cativa,  etc.  New  York,  1771. 
Beardsley,  H.,  Congenital  hypertrophic  stenosis  of  the  pylorus.  Cases 

and  observations  by  the  medical  society  of  New  Haven  County. 

New  Haven,  1788. 
Blankaart,  S.,  Verhandelinge  van  de  opvoedinge  en  ziekten  der  kinderen. 

120.  t*  Amsterdam,  1684. 
Blondus  (Biondo),  M.  A.,  De  affectibus  infantium  et  puerorum.  Ab. 

Hypp.,     Gal.,     Ras.,     Haliab.     atque     Aeginetae     monumentis 

deprompta.  8°.  [Romae],  1539. 
Bouvier,  S.,  *De  affectibus  nonnullis' infantium.  40.  Lugd.  Bat.,  1670. 
Briart,  J.  P.,  *De  regimine  et  morbis  infantum.  1768.  In:  Louvian  Diss., 

i,  112. 


566  PEDIATRICS  OF  THE  PAST 

Cadogan,  Essay  (An)  upon  nursing,  and  the  management  of  children, 
from  their  birth  to  three  years  of  age.  By  a  physician.  In  a  letter  to 
one  of  the  governors  of  the  hospital.  8°.  London,  1748.  [Author's 
name  not  given.] 

Cadogan,  W.,  An  essay  upon  nursing,  and  the  management  of  children, 
from  their  birth  to  three  years  of  age.  In  a  letter  to  one  of  the 
governors  of  the  Foundling  Hospital.  Ed.  4.  8°.  London,  1750. 
Ed.  6.  8°.  London,  1753. 
Ibid.,  1772. 

Caldwell,  C,  An  attempt  to  establish  the  original  sameness  of  three 
phenomena  of  fever  (principally  confined  to  infants  and  children), 
described  by  medical  writers  under  the  several  names  of  hydro- 
cephalus internus,  cynanche  trachealis,  and  diarrhoea  infantum.  8°. 
Philadelphia,  1796. 

Camper,    P.,    Aanmerkingen   over  de  inentinge  der  kinderziekte  met 
Waarneemingen  bevestigd.  8°.  Leeuwarden,  1770. 
Verhandeling  over  het  bestuur  van  kinderen.  8°.  Amsterdam,  1800. 

Cascales,  F.  P.,  Liber  de  affectionibus  puerorum  una  cum  tractatu  de 
morbu  illo  vulganter  garotillo  appellato,  cum  duabus  quaestionibus. 
Altera  de  gerentibus  utero  rem  appetentibus  denegatum.  Altera 
vero  de  fascinatione.  40.  Matriti,  161 1. 

Chambon  [de  Montaux],  N.,  Des  maladies  des  enfans.  2  v.  8°.  Paris,  an 
yn  [1798]. 
Ibid.  1799. 

Chavernac,  J.,  *Considerations  sur  les  rapports  que  presentent  entr'- 
elles  les  facultes  vitales  pendant  Tenfance.  40.  Montpellier,  an  vi 

[1798]. 
Convalescent    Institution    for   Women   and   Children,  New  Brighton. 
Annual  reports  of  the  committee  to  the  subscribers,  for  the  years 
1874;  1879-81;  1883-6.  8°.  Liverpool,  1775-87. 
Conyers,  R.,  *De  morbis  infantum.  40.  Lugd.  Bat.,  1729. 

Ibid.  8°.  Londini,  1748. 
Cooke,  J.,  A  plain  account  of  the  diseases  incident  to  children,  with 
an  easy  method  of  curing  them;  designed  for  the  use  of  families.  8°. 
London,  1769. 
Ibid.  Maladies  des  enfans.  Trad,  de  Panglois.  160.  Yverdon,  1770. 
Malattiede*  fanciulli.  120.  Napoli,  1781. 
Cregutus,  F.  C,  ^Egritudines  infantum  ac  puerorum,  quarum  originem 
et  curam  meditatione  iatrica  inaugurali  submittit.  Sm.  40.  Basileae, 
[1696]. 
Daignan,  G.,  Gesundheitslehre  in  Beziehung  auf  das  kindliche  und 
mannbare  Alter.  Ein  Beytrag  zur  medizinischen  Erziehungskunde. 
Aus  dem  Franz osischen.  2  pts.  120.  Leipzig,  1788. 


ADDITIONAL  PEDIATRIC  BIBLIOGRAPHY       567 

Schilderung  der  Veranderungen  des  menschlichen  Lebens,  oder  von 
den  Krankheiten  des  mannbaren  Alters  und  ihrer  Behandlung,  mit 
den  Vortheilen  und  Nachtheflen  jeder  Constitution  und  mit  uberaus 
wichtigen  Warnungen  fur  die  Eltern  in  Rucksicht  der  Gesundheit 
ihrer  Kinder  des  einen  und  andern  Geschlechts,  besonders^in 
dem  Alter  der  Mannbarkeit.  120.  Leipzig,  1789. 

DeLeurye,  fils.  La  mere  selon  Tordre  de  la  nature;  avec  un  traite  sur  Ies 
maladies  des  enfans.  160.  Paris,  1772. 

Desessarts,  J.  G,  Traite  de  T education  corporelle  des  enfans  en  bas  age, 
ou  reflexions  pratiques  sur  Ies  moyens  de  procurer  une  meilleure 
constitution  aux  citoyens.  2.  ed.,  augmentee  d'un  avertissement  et 
d'un  supplement.  8°.  Paris,  an  vn  [1799]- 

Deux  memoires :  Ie  premier,  sur  la  conservation  des  enfans,  et  j\ine 
destination  avantageuse  des  enfans  trouves;  Ie  second,  sur  Ies 
biens  de  THopital  S.  Jacques,  Ieur  etat  actuel  et  Ieur  veritable 
destination.  160.  [Paris],  1756. 

Dimler,  F.  J.,  *Diss.  med.  difficultates  in  curatione  morborum  infanti- 
Iium  obvenientes  succincte  exponens.  Sm  40.  Gottingae,  1782. 

Edinburgh  Merchant  Company.  The  rules  and  constitutions  for  govern- 
ing and  managing  the  Maiden  Hospital,  founded  by  the  Company 
of  Merchants  and  Mary  Erskine,  in  anno  1695.  Allowed  and  con- 
firmed by  an  act  of  Parliament  of  Her  Majesty  Queen  Anne,  dated 
25th  March,  1707.  Amended  and  approved  .  .  .  Feb.  9,  1708. 
Ratified  by  the  lord  provost  .  .  .  upon  the  19th  March  the  said 
year.  With  an  alphabetical  list  of  the  donators  and  benefactors  to  the 
said  hospital  preceding  the  first  of  September,  1708.  120. 
Edinburgh,  1708. 

Engelman,  J.,  *Diss.  sistens  considerationem  infantiae  medicam.  40. 
Lugd.  Bat.  [1733]. 

Englische  (Der)Kinderarzt  nach  den  Grundsatzen  der  Herren  Moss  und 
Underwood.  8°.  Leipzig,  1786. 

EttmuIIer,  M.,  Valetudinarium  infantile.  Sm  40.  Lipsiae,  1675. 
(PR)  de  ingenio  praematuro.  40.  Lipsiae,  1725. 

Faventinus,  L.  [Victorius]  Practica  medicinalis  cum  scholiis.  Johannis 
Kufneri.  De  aegritudinibus  infantum,  eodem  authore  tractatus,  160. 
Lugdini,  1554. 
De  aegritudinibus  infantium  tractatus  admodum  salutifer.  De 
eadem  tractatione  appendicula,  priore  haud  minus  frugifera, 
per  Georgium  Khufnerum  juniorem  exarata.  Accedit  etiam 
oratiuncula,  in  celebri  Iiteratissimorum  virorum  concessu  Ingold- 
stadii,  per  eundem  jamjam  citatum  authorem  publice  habita. 
120.  (Ingoldstadii,  1544.) 
Ibid.  1 6°.  Venetiis,  1557. 

Fellinger,  C.  G.,  *De  morbis  infantum.  40.  Duisburgi  ad  Rhenum,  1738. 


568  PEDIATRICS  OF  THE  PAST 

Ferrarius   O.,  De  arte  medica  infantfum,  Iibri  quatuor,  quorum  duo 

priores  de  tuenda  eorum  sanitate,  posteriores  de  curandis  morbis 

agunt.  4°.  Brixiae,  1577. 
De  arte  medica  infantium  aphorismorum,  particulae  tres.  Sm.  40. 

Brixiae,  1577. 
Ibid.  120.  Wittebergae,  1604. 
De  arte  medica  infantium,  Iibri  quatuor.  Quorum  duo  priores  de 

tuenda  eorum    sanitate,    posteriores    de  curandis    morbis   agunt. 

Ejusdem    item     de    eadem    aphorismorum    particulae    tres.    In 

Germania  nunc  primum  edit.  120.  Lipsiae,  1605. 
Fontanus,  N.,  Commentarius  de  puerorum  morbis.  180.  Amstelodami, 

1642. 
de  Fourcroy,  A.  F.,  Les  enfans  eleves  dans  I'ordre  de  la  nature,  ou 

abrege  de  I'histoire  naturelle  des  enfans  du  premier  age.  A  I'usage  des 

peres  et  meres  de  famille.  160.  Paris,  1775. 
Frank,  J.  P.,  Traite  sur  la  maniere  d'elever  sainement  les  enfans  fonde 

sur  les  principes  de  la  medecine  et  de  la  physique.  Traduit  de 

I'allemand  par  M.  Boehrer.  8°.  Paris,  1799. 
Friis,  C.  L.,  *De  morbis  puerorum  secundum  Hippocratis  Aphor.  xxvi, 

xxvii  sect.  iii.  40.  Hafniae,  1748. 
Full   (A)   [Full  is  not  an  author]  view  of  all  the  diseases  incident  to 

children.  Containing  a  translation  of  Dr.  Harris's  book  upon  the 

acute  diseases  of  infants,  and  of  the  eminent  Dr.   Boerhaave's 

treatise  upon  all  their  diseases,  as  well  acute  as  chronical.  Together 

with  a  careful  abridgement  of  the  best  authors  who  have  wrote  upon 

their  particular  diseases,  viz:  Sylvius  on  the  thrush,  Willis  on  the 

epilepsy,  Sydenham  on  the   small-pox, — on  the  measles,  Andry  on 

worms,  Burton  on  the  chin-cough,  Glisson  on  the  rickets,  Wiseman 

on  the  King's  evil  (etc.).  120.  London,  1742. 
[Gattenhof,  G.  M.],  De  curis  infantum.  (1766).  In:  CoIIectio  dissertatio- 

num,  [etc.]  8°.  Heidelbergae,  1791,  i,  157-252.  Geiger,  M.,  *Praxin 

clinicam    morborum  infantum  publico  examini  sistit.   40.  Halae. 

Magdeb.  [171 5]. 
Girtanner,  C,  Abhandlung  iiber  die  Krankheiten  der  Kinder  und  iiber 

die  physische  Erziehung  derselben.  8°.  Berlin,  1794. 
Glisson,  F.,  De  Rachitide,  Londini,  1650. 
Gohierre-Longschamps,  M.  B.,  Essai  sur  quelques  maladies  des  enfans. 

120.  Montpellier,  1792. 
Guillemeau,  J.,  The  nursing  of  children,  wherein  is  set  downe  the  ordering 

and  government  of  them  from  their  birth.  Together  with  the  means 

to  helpe  and  free  them  from  all  such  diseases  as  may  happen  unto 

them.  Written  in  French.  Sm.  40.  London,  1612. 
Ibid.,  1635. 


ADDITIONAL  PEDIATRIC  BIBLIOGRAPHY      569 

De  la  nourriture  et  gouvernement  des  enfans;  des  Ie  commencement 

de  Ieur  naissance;  et  Ie  moyen  de  Ies  secourir  et  garantir  des  maladies 

qui  Ieur  peuvent  survenir  des  Ie  ventre  de  Ieur  mere,  et  premier  age. 

In  his:  De  la  grossesse  (etc.).  8°.  Paris,  1643,  542~774- 

Gundlfinger,  J.  G.  A.,  *De  cardiogmo,  vom  Anwachsen  der  Kinder.  40. 

Argentinae,  1747. 
Harris,  W.  [G],  De  morbis  acutis  infantum.  160.  Londini,  1689. 

De  morbis  acutis  infantum.  Griindlicher  Bericht  von  den  schnellen 
gefahrlichsten  Kranckheiten  junger  Kinder  .  .  .  Anjetzo  aber  in 
das  Hochtenutsche  iibersetzt,  und  mit  einem  fernern  Anhang  von 
andern  Zustanden  junger  Kinder  und  beygef  ugten  ebenmassigdenck- 
wurdigen  Anmerckungen  vermehrt.  160.  Franckfurt  u.  Leipzig,  1691. 

De  morbis  infantum.  Tractatus  de  morbis  acutis  infantum  variis 
observationibus  illustratus.  40.  Genevae,  1696.  In:  Morton  R.  Opera 
medica.  40.  Genevae,  1696,  1-44. 

De  morbis  acutis  infantum.  8°.  Amstelodami,  1698. 

Ed.  3.  8°.  Londini,  1720. 

Ed.  4.  120.  Amstelaedami,  1736. 

De  morbis  acutis  infantum.  120.  Amstelodami,  1698.  In:  Morton,  R. 
Opera  medica.  120.  Amstelodami,  1699,  iv. 

De  morbis  acutis  infantum.  2  ed.,  priori  auctior.  Cui  accessit  liber 
observationes  de  morbis  aliquot  gravioribus  medicas  complectens. 
Annexis  etiam  quibusdam  de  Iuis  venereae  origine,  natura  et  cura- 
tione.  8°.  Londini,  1705. 

De  morbis  acutis  infantum.  Accessere  observationes  medicae  de 
morbis  aliquot  gravioribus,  et  quaedam  de  Iuis  venereae  origine, 
natura  et  curatione.  Editio  nova  auctior  et  accuratior.  160.  Amstelo- 
dami, 1 7 15. 

De  morbis  acutis  infantum.  Ed.  3.  8°.  Rotterodami,  1720. 

De  morbis  acutis  infantum.  Traite  des  maladies  aigues  des  enfans 
.    .    .  trad,  du  latin  sur  la  2.  ed.  par  M.  Devaux.  120.  Paris,  1730. 

De  morbis  acutis  infantum.  Lugdini,  1718.  40. 

Also,  in:  Morton,  R.     Opera  medica.  Sm.  40.  Lugduni,  1737,  ii,  1-84. 

De  morbis  acutis  infantum.  120.  Paris,  1738. 

De  morbis  acutis  infantum.  A  treatise  of  the  acute  diseases  of  infants. 
To  which  are  added  medical  observations  on  several  grievous 
diseases.  Transl.  into  English  by  John  Martyn.  8°.  London,  1742. 
Heintke,  G,  Valetudinarium  infantile.  40.  Lipsiae  [1675]. 
Hellwig,  G,  Curieuser  Kinder-  Jungfer-  und  Weiber-Spiegel ;  worinnen 
zu  sehen:  1.  Wie  mit  Kindern,  deren  Aufferziehung,  zustossenden 
Kranckheiten,  nebst  rechtmassiger  Cur  zu  verfahren,  mit  schonen 
Observationibus.  11.  Wie  Jungfern,  Wittben,  und  Iediges  Frauen- 
Zimmer  bey  alien  ereigneten  Maladien  und  Unpasslichkeiten  zu 
tractiren.  120.  Franckfurt  u.  Leipzig,  1720. 


570  PEDIATRICS  OF  THE  PAST 

Honisch,  C,  *De  infantum  affectibus.  40.  Halae  Magdeb.  [1705]. 

Huartes,  J.,  Examen  de  ingenios  para  las  ciencias,  en  el  qual  el  lector 
hallara  la  manera  de  su  ingenio,  para  escoger  la  ciencia  en  que  mas 
ha  de  aprovechar;  y  la  diferencia  de  habilidades  que  ay  en  Ios  hom- 
bres,  y  el  genero  de  Ietras,  y  artes  que  a  cada  uno  responde  en  par- 
ticular. Agora  nuevamente  emendado  por  el  mismo  autor,  y 
anadidas  muchas  cosas  curiosas  y  provechosas.  8°.  Madrid,  1668. 
Examen  de  Ingenios.  The  Examination  of  mens  Wits,  in  which,  by 
discovering  the  varietie  of  natures,  is  shewed  for  what  profession 
each  one  is  apt,  and  how  far  he  shall  profit  therein.  Translated  out 
of  the  Spanish  tongue  by  M.  Camillo  Camilli.  Englished  out  of  his 
Italian  by  R.  C.  Esqure.  London,  161 6.  Printed  by  Adam  Flip,  for 
Thomas  Adams. 
Ibid.  Examen  de  ingenios :  or  the  tryal  of  wits.  Discovering  the  great 
difference  of  wits  among  men,  and  what  sort  of  learning  suits  best 
with  each  genius.  Made  English  from  the  most  correct  edition  by 
[Edwd.]  Bellamy.  8°.  London,  1698. 

Hullesheim,  J.  B.,  *De  morbis  infantum.  40.  Lugd.  Bat.,  1720. 

I.  I.  H.,  Sonderbahre  ntitzliche  auch  nothige  Anmerkungen  eine  sorgfal- 
tige  Aufferziehung  der  jungen  Kinder  und  deren  Gebrechen  betref- 
fend.  Allen  sorgfaltigen  Miittern  zur  nothigen  Unterricht  mitge- 
theilet.  240.  Nurnberg,  1688. 

Isaacus,  C.  T.,  *De  morbis  puerorum.  40.  Halae  Magdeb.[  1746]. 

Jameson,  J.,  *De  infantum  morbis,  ab  infantia  ortis.  8°.  Edinburgh  1731. 

Knackfuss,  C.  G.,  *De  paedatrophia.  Sm.  40.  Jenae  [1792]. 

de  Kozamerus,  J.  M.,  Informatio  de  secura  infantum  valetudine  tuenda  in 
natura  et  hujus  libertate  fundata  accurate  per  naturae  explica- 
tionem,  diaeteticum  regimen,  abusuum  abrogationem,  domesticae 
medicandi  methodi  institutionem  [etc.].  120.  Vratislaviae,  171 7. 

Krautermann,  V.,  (Pseud).  Getreuer,  sorgfaltiger  und  geschwinder 
Kinder-Artzt,  welcher  die  auserlesensten,  sichersten  und  bewahr- 
testen  Artzney-  und  Hauss-Mittel,  vor  alle  und  jede  Krankheiten 
junger  und  erwachsener  Kinder,  an  die  Hand  giebet,  aus  bewahrter 
Medicorum  Schrifften,  theils  auch  aus  eigner  Experientz,  vornehm- 
Iich  aber  nach  der  Methode  des  seel.  Herrn  D.  Wedelii,  nebst 
nothigen  Registern,  aus  Licht  gestellet.  120.  Franckf.  &  Leipzig,  1722. 
Lehre  von  den  Kinder  Krankheiten;  neur  durchgehends  verbesserte 
Auflage  von  Johann  Gottfried  Essich.  120.  Augsburg,  1792. 

Logan,  G.  C.,  *De  morbis  infantium  arcendis  et  curandis.  8°.  Edinburgi, 

1773- 
London,  Hospital  for  the  Maintenance  and  Education  of  Exposed  and 
Deserted  Young  Children.  A  copy  of  the  royal  charter.  8°.  London, 
1739. 


ADDITIONAL  PEDIATRIC  BIBLIOGRAPHY       571 

Hospital  for  the  Maintenance  and  Education  of  Exposed  and  Deserted 
Young  Children.  The  report  of  the  general  committee  .  .  .  relat- 
ing to  the  general  plan  for  executing  the  purposes  of  the  royal 
charter,  establishing  this  hospital.  8°.  London,  1740. 

Hospital  for  the  Maintenance  and  Education  of  Exposed  and  Deserted 
Young  Children.  The  royal  charter,  establishing  an  .  .  .  With  the  act 
of  Parliament  establishing  the  same.  Together  with  the  by-laws  of  the 
said  corporation,  and  the  regulations  for  managing  the  said  hospital. 
Together  with  the  accounts  of  the  said  hospital  from  its  commence- 
ment till  25.  March,  1745,  anoT  a  ^st  °f tne  governors  on  the  said  25. 
March.  8°.  London,  1746. 

Hospital  for  the  Maintenance  and  Education  of  Exposed  and  De- 
serted Young  Children.  An  account  of.  .  .  In  which  are  the  char- 
ter, act  of  Parliament,  by-laws  and  regulations  of  the  said 
corporation.  8°.  London,  1749. 

Hospital  for  the  Maintenance  and  Education  of  Exposed  and  Deserted 
Young  Children.  Regulations  for  managing  the  ...   8°.  London, 

1757. 
Hospital    for    the    Maintenance    and    Education    of    Exposed  and 
Deserted  Young  Children.  The  charter,  act  of  Parliament,  by-laws 
and  regulations.  8°.  London,  1799. 
Luderss,  J.  C,  *De  educatione  Iiberorum  medica.  40.  Goettingae  [1763]. 
Ludwig,  C.  G.,  *[Pr.]  de  contentione  studiorum  in  puerili  aetate  cavenda. 

4°.  [Lipsiae,  1767]. 
Mancinellus,  A.,  De  parentum  in  Iiberos.  De  filiorum  erga  parentes 

obedientia,  honore  &  pietate.  40.  Argentorati,  15 12. 
Mauriceau,  F.,  Traite  des  maladies  des  femmes  grosses  .    .    .   et  aux 
indispositions  des  enfans  nouveau-nes  .    .    .   Ed.  3.  40.  Paris,  1681. 
Trattato  delle  malattie  delle  donne  gravide  e  delle  infantate.  40. 

Cologni,  1684. 
Observations  sur  la  grossesse  et  Paccouchement  des  femmes,  et  sur 

Ieurs  maladies  et  celles  des  enfans  nouveau-nes.  8°.  Paris,  1695. 
Ibid.  40.  Paris,  17 15. 
Mayow,  J.  De  rachitide,  1669. 

Mercurialis,  H.,  De  puerorum  morbis  tractatus.  120.  Francofurti,  1584. 
Ibid.  40.  Venetiis,  1615. 

Nomothelasmus  seu  ratio  Iactandi  infantes.  Patavii,  1552. 
De  puerorum  morbis  tractatus.  40.  Venetiis,  1615.  1584.  15 16.  German 

translation,  1605. 
De    morbis    puerorum    tractatus    Iocupletissimi,    variaque    doctrina 
referti  non  solum  medicis,   verum  etiam  philosophis  magnopere 
utiles.  Ex  ore  .    .    .   diligenter  excepti,  atque  in  Iibros  tres  digesti, 
opera  Johannis  Chrosczieyoioski.  Venetiis,  1583. 


572  PEDIATRICS  OF  THE  PAST 

The  same.  De  morbis  puerorum;  item  de  veneris  et  morbis  venenosis; 

qufbus  adjuncta  est  censura  Hippocrata.  120.  Basileae,   1584. 
Also,  in  his:  Tractatus  varii  (etc.).  8°.  Lugduni,  1623,   1-188,  6  1., 

1-69,  3  L. 
Metlinger,  B.,  [Regiment  der  jungen  Kinder.]  [Incipit]:  Wann  nach  Anse- 

hung  gotlicher  und   menschlicher  Ordenung,  etc.  fol.  Augsburg, 

Ein  Regiment  der  jungen  Kinder.  [Ad  finem]:  Gedruckt  und  volendet 

von  Johi.  Bamler,  zu  Augspurg.  An  Sauct  Augusteins  Tag  als  man 

zalt  nach  Christie  geburt  tausent  vierhundert  und  in  dem  lxxiiii 

jar.  Fol.  [Augspurg,  1474]. 
Third  edition.  Small  40.  Baemler  Montag  vor  sant  Laurenzen  tag 

anno  JC  in  dem  ixxxvi  jare  [August  5,  1476]. 
Fourth  edition  printed  by  Hans  Schauren.  Und  saligklich  volendet  am 

Freitag  vor  martini.  Als  man  zalt  nach  der  gepurt  Cristi  insers 

Iieben  herren  Tausant  vier  hundert  und  in  dem  sib  und  niintzugis- 

ten  jar.  (November  10,  1497.) 
Fifth  edition.  Im  iubel  iar  als  man  ze  let  nach  Christi  unsers  herren 

Geburt  Mccccc  iar.  (February  13,  1500.) 
Sixth    edition.    Hansen    Schensperger    den    Jungen    zu    Augspurg. 

(February  10,  151 1.) 
Seventh  edition,  with  Die  Heymlicheytenn  Alberti  Magni. 
Numerous  editions  with  other  works,  as  with  Louffenburg's  poem, 

Franckturt  am  Mayn,  1549. 
Frequently  reprinted  with  Roslin's  Rosegarten,  in  German,  Dutch, 

French  and  English. 
English  translation  by  Jonas,  1542. 
Reprinted  by  Thomas  Raynalde  with  changes  and  additions  1545,  1555, 

1560,  1564?,  1565,  1593?,  1598,  1604,  1 613,  1626,  1634,  1654.  1676. 
Unger  edition.  Leipzig  und  Wien,  1894. 
Mireur.  Dissertation  sur  quelques  maladies  des  enfans.  120.  Montpellier, 

1791. 

Moss,  W.,  An  essay  on  the  management,  nursing,  and  diseases  of 
children  from  the  birth;  and  on  the  treatment  and  diseases  of  preg- 
nant and  lying-in  women,  with  remarks  on  the  domestic  practice  of 
medicine.  To  which  is  now  added,  the  treatment  and  diseases 
of  children  at  more  advanced  periods  of  childhood.  Ed.  2.  8°. 
Egham,  1794. 

MuIIerus,  J.  G.  *De  morbis  infantum.  40.  Halae  Magdeb.  [1746]. 

New  Brighton,  Convalescent  Institution  for  Women  and  Children. 
Annual  reports  of  the  committee  to  the  subscribers  for  the  years 
1874;  1879-81;  1883-6.  8°.  Liverpool,  1775-87. 

Obele,  J.  G.,  Disputatio  de  morbis  puerorum  juxta  Hippocratem.  40. 
Giessae,  161 8. 


ADDITIONAL  PEDIATRIC  BIBLIOGRAPHY       573 

Observations  upon  the  proper  nursing  of  children.  8°.  London,  1761. 

Oehme,  C.  J.,  *De  morbis  recens  natorum  chirurgicis.  40.  Lipsiae,  1773. 

Oomen,  H.,  *De  causis  morborum  infantilium  in  genere.  Sm.  40.  Duis- 
burgiad  Rhenum,  [1763]. 

Orphan  Hospital  and  Workhouse  at  Edinburgh. 

Statutes  of  the  corporation  of  the  .  .  .  To  which  is  prefixed  an 
account  of  the  hospital  from  its  establishment,  in  1733.  I2°-  Edin- 
burgh, 1777. 

Pemel,  R.  De  morbis  puerorum;  or,  a  treatise  of  the  diseases  of  children; 
with  their  causes,  signs,  prognosticks,  and  cures,  for  the  benefit  of 
such  as  do  not  understand  the  Latine  tongue,  and  very  useful  for  all 
such  as  are  house-keepers  and  have  children.  8°.  London,  1653. 

Phaer  or  Phayre,  Thomas.,  The  Regiment  of  Life,  wherunto  is  added  a 
treatise  of  the  pestilence,  with  the  boke  of  children,  newly  corrected 
and  enlarged.  1545. 
According  to  Herbert  there  was  a  1544  edition.  There  are  said  to  be  the 
following  editions:  1546,  1553,  1560,  1565(7),  1567,  1570(7),  1596. 

Pictorius  (G)  Villinganus.,  De  instituendis  pueris.  Quibus  praeceptoribus 
committenda  sit  ingenuorum  puerorum  indoles,  quibusve  artibus 
instituenda,  ut  recte  cum  pro  corporis  informetur  habitu,  turn  etiam 
ad  mentis  veram  traducatur  condecentiam,  isagoge.  Cum  brevi 
admodum  mathesi,  qua  ratione  vel  Iabefactans,  vel  deperdita 
restauretur  fidelissima  musarum  genitrix  memoria.  Annexo  dramate 
satis  jucundo  de  sene  quodam  turpi  amore  impedito,  et  honesta 
uxore  desolata.  180.  Basileae,  [1564]. 

Portenschlag-Ledermayer,  J.,  *De  educatione  physica  infantum.  40. 
Vindobonae,  1765. 

Primerose,  J.,  Partes  duae  de  morbis  puerorum.  240.  Roterodami,  1659. 

Raulin,  J.,  De  la  conservation  des  enfans,  ou  Ies  moyens  de  Ies  fortifier, 
de  Ies  pereserver  et  guera  des  maladies  depriis  Tinstant  de  Ieur 
existence,  jusqua  Page  de  puberte.  2  v.  in  3.  8°.  Paris,  1768-9. 

Rhodian,  E.,  De  partu  hominis,  et  quae  circa  ipsum  accidunt,  adeoque 
de  parturientium  et  infantium  morbis  atque  cura  Iibellus.  160. 
Francofurti,  1563. 

Roederer,  J.  G.,  [Pr.],  Praemissis  ex  cadaveribus  infantum  morbosis 
observationibus.  40.  Gottingae.  [1758]. 

Roelans  or  Roelants,  C.  Libellu  egritudinis  infantum  (J.  Veldener 
Lowen  1483  or  1484  according  to  Jenkinson). 

Rogerson,  J.,  *De  morbis  infantum.  8°.  Edinburgi,  1765. 

Rosen  von  Rosenstein,  N.,  Underrattelse  om  barns  sjukdomar  och  deras 
bote-medel.  Anweisung  zur  Kenntniss  und  Cur  der  Kinderkrank- 
heiten,  aus  dem  Schwedischen  iibersetzt  und  mit  Anmerkungen 
erlautert  von  J.  A.  Murray.  12°.  Gotha  u.  Gottingen,  1766. 


574  PEDIATRICS  OF  THE  PAST 

Underrattelse  om  barns  sjukdomar  och  deras  bote-medel.  2  Aufl.  120. 

Gottingen  u.  Gotha,  1768. 
Ibid.  3.  upl.  8°.  Stockholm,  1771. 
Underrattelse   om   barns  sjukdomar  och  deras  bote-medel.   Nebst 

Lebensbeschreibung  des  Hrn.  Verfassers.  3  vermehrte  und  verbes- 

serte  Aufl.  120.  Gottingen  u.  Gotha,  1774. 
Underrattelse  om  barns  sjukdomar  och  deras  bote-medel.  The  diseases 

of  children,  and  their  remedies.  Transl.  into  English  by  Andrew 

Sparrman.  8°.  London,  1776. 
Traite  des  maladies  des  enfans.  Traduit  du  suedois  pas  M.  Le  Febvre 

de  Villebrune.  8°.  Paris,  1778. 
Underrattelse  om  barns  sjukdomar  och  deras  bote-medel.  Trattato 

delle  malattie  dei  bambini.  Trasportato  dal  tedesco  con  alcune 

note  da  Giovanni  Battista  Palletta.  8°.  Milano,  1780. 
Underrattelse  om  barns  sjukdomar  och  deras  bote-medel.  120.  Bassano, 

1783. 
Ibid.  Neueste  Aufl.  120.  Wien,  1787. 

Anweisung   zur    Kenntniss    und    Kur   der   Kinderkrank — aus    dem 
Schwedischen   ubersetzt  und  mit  Anmerkungen  erlautert  heiten. 
Neueste  Aufl.  120.  Wien.  1787.  von  J.  A.  Murray. 
Traite  des  maladies  des  enfans.  Traduit  du  suedois  par  M.  Le  Febvre 

de  Villebrune.  8°.  Paris.  1793. 
Underrattelse  om  barns  sjukdomar  och  deras  bote-medel.  6  Aufl.  120. 

Gottingen,  1798. 
Anweisung  zur  Kenntniss  und  Kur  der  Kinderkrankheiten.  Ueber- 
setzt  und  mit  Zusatzen  von  J.  A.  Murray;  6.  Aufl.,  mit  Anmerkungen 
von  J.  C.  Loder  und  von  W.  H.  S.  Bucholz.  120.  Gottingen,  1798. 
Rougemont,  J.  C.,  Etwas  iiber  Kleidertracht,  in  wie  feme  sie  einen 
nachtheiligen    Einfluss   auf  die   Gesundheit   hat.    Nebst   einigen 
anatomischen  und  chirurgischen  Beobachtungen.  40.  [Bonn,  1784]. 
Rush,  B.,  An  inquiry  into  the  cause  and  cure  of  cholera  infantum.  Phila- 
delphia. 
S.,  J.,  See  Siegel,  J.  V.  H. 

de  Sainte  Marthe,  (Scevola)  [Sammarthanus].  Paedotrophia;  or,  the  art 
of  nursing  and  rearing  children.  A  poem,  in  three  books.  Transl. 
H.  W.  Tytler,  8°.  London,  1797. 
de  Sauvages,  F.  B.,  De  morbis  puerorum.  120.  Neapoli,  1778. 

Forms  Vol.  1  of  his :  Tractatus  method,  pract.  120.  Neapoli,  1778. 
Schaffer,   F.  C.  G.,  Ueber  die  gewohnlichsten  Kinderkrankheiten  und 
deren  Behandlung.  Nach  Armstrong  neu  bearbeitet.  [2nd   Aufl.] 
8°.  Regensburg,  1792. 
Schlicht,   G.,   *De  quatuor  praecipuis  infantum  morbis  compendiaria 
ac  felici  methodo  curandis.  40.  Halae  Magdeb.  [1758]. 


ADDITIONAL  PEDIATRIC  BIBLIOGRAPHY       575 

Schmid,  J.  S.,  *Spec.  sistens  aphorismos  de  cognoscendis  et  curandis 
infantum  morbis.  Sm.  40.  Francof.  ad  Viadr.  [1750]. 

Schroder,  J.,  *De  morbis  infantum,  pars  prima.  Sm.  40.  Upsaliae  [1752]. 

Schulze,  J.  S.  J.,  *De  morbis  infantum  ex  matura  indulgentia.  Sm.  40. 
Goettingae,  1759. 

Schumann,  G.  A.,  De  erroribus  quibusdam  educationis  infantum  tenel- 
Iorum  a  perverso  parentum  amore  oriundis.  40.  Witebergae  [1790]. 

Sebizius,  M.,  Jun.,  *De  infantium  et  puerorum  morbis.  Resp.  Georgius 
Godofredus  Zillinger.  Sm.  40.  Argentorati  [1649]. 

Senshi.  Shioga  zoku  getsu.  [Treatise  on  the  diseases  of  children.] 
Compiled  by  K.  Setsu.  3  v.  8°.  [Kioto,  1799]. 

S.,  J.,  JIAIA&N  NOSHMATA,  or  children's  diseases,  both  outward 
and  inward,  from  the  time  of  their  birth  to  fourteen  years  of  age; 
with  their  natures,  causes,  signs,  presages  and  cures;  in  three  books: 
1 .,  of  external  diseases;  2.,  of  universal  disases;  3.,  of  inward  diseases; 
also  the  resolutions  of  many  profitable  questions  concerning  chil- 
dren, and  of  nurses,  and  of  nursing  children.  160.  London,  1664. 

Siegel,  J.  V.  H.,  *De  cura  neonatorum  medica.  40.  Gottingae,  1782.  Also 
transl.  in:  Weiz,  F.  A.,  Neue  Ansz.  (etc.)  120.  Frankf.  u.  Leipz., 
1783,  xviii,  1-44. 

Slevogt,  J.  H.,  and  Buchelmann,  J.  S.,  Rhoncus  infantis  ex  ulcerum 
paroticorum  intempestiva  curatione  variis  symptomatibus  stipatus. 
Jenae,  1699.  In:  Haller  Disp.  ad  morb.  ii. 

Smith,  H.,  Letters  to  married  women  on  nursing  and  the  management  of 
children.  2  Am.  ed.  8°.  Philadelphia,  1796. 

Sommer,  J.  G.,  Kurtze  Anleitung  zur  christlichen  Kinder-Zucht,  in 
gewisse  Regulen  gefasset.  160.  Jena,  1676. 

Storch,  J.,  Theoretische  und  practische  Abhandlung  von  Kinder- 
Kranchkeiten,  darinnen  die  Theorie  auf  richtige  Grunde  gebauet, 
die  Praxis  nach  denenselben  eingerichtet,  und  die  mit  vieler  Erfah- 
rung  bestarckte  Curen,  durch  Gottliche  Gnade,  gliicklich  gefiihret 
worden.  120.  Eisenach,  1750. 

Strobelberger,  J.  S.,  Brevissima  manuductio  ad  curandos  pueriles  affectus 
ad  praxin  medicam  accedentibus  maxime  usui  futura,  et  fidelissime 
communicata.  120.  Norimbergae,  1625. 
Ibid.  Lipsiae,  1629. 

Strodtmann,  J.  C,  *De  nonnullis  parentum  deliciis  in  morbos  infantum 
plerumque  degenerantibus.  40.  Gottingae  [1767]. 

Struve,  C.  A.,  Neues  Handbuch  der  Kinderkrankheiten,  besonders  zum 
gebrauch  fiir  Eltern  und  Erzieher.  120.  Breslau,  1797. 

Sylvius  (de  Ie  Boe),  F.,  Praxeos  medicae  liber  quartus;  de  morbis  infan- 
tum, et  aliis  quibusdam  memoratu  dignis  afFectibus.  Editus  cura 
Justi  Schraderi.  240.  Amstelodami,  1674. 


576  PEDIATRICS  OF  THE  PAST 

Praxeos  medicae  liber  quartus.  Of  children's  diseases :  given  in  a  fami- 
Iiare  style  for  weaker  capacities,  with  an  apparatus,  or  introduction, 
explaining  the  author's  principles;  as  also  a  treatise  on  the  rickets. 
12°.  London,  1682. 
Toletus,  P.,  Opusculum  recens  natum  de  morbis  puerorum,  cum  appendi- 
cibus;  sunt  etiam  nonnulli  additi  Iibelli  perutiles,  hactenus  desider- 
ati,  quos  sequens  pagella  demonstrabit.  120.  Lugduni,  1538.  (A 
reprinting  of  Bagellardus.) 
Tractatus  duo  pathologici,  nunc  primum  in  Iucem  editi,  auctore  medico 

Monspeliensi  in  praxi  felicissimo.  120.  Amstelodami,  1760. 
Tranensis,  P.,  Libellus  de  ingenuis  puerorum  et  adolescentium  moribus 

.    .    .   feliciter  incipit.  40.  [Farrariae,  1496.] 
Treatise    (A)   on  the  diseases  of  infants  and  children.   8°.   London, 

1772. 
Underwood,  M.,  A  treatise  on  the  diseases  of  children.  London,  1784. 
Traite  des  maladies  des  enfans.  Auquel  on  a  joint  Ies  observations 
pratiques  de  M.  Armstrong,  et  celles  de  plusieurs  autres  medecins. 
Traduit  de  Panglois  [par  Lefebvre  de  Villebrune].  8°.  Paris,  1786. 
A  treatise  on  the  diseases  of  children,  with  general  directions  for  the 
management  of  infants  from  the  birth.  A  new  ed.  2  v.  in  1.  160. 
London,  1789. 
Ibid.  2  v.  in  1.  8°.  Philadelphia,  1793. 
Ibid.  1 6°.  Philadelphia,  1793. 

Ibid.  Adapted  to  domestic  use.  3  v.  120.  London,  1797. 
Ibid.  Ed.  4.  3.  v.  120.  London,  1799. 

Ibid.  1 80 1.  1 8 19.  Revised  by  S.  Merriman,  1826;  by  M.  Hall,  1835; 
and  by  H.  Da  vies,  1846. 
Van  der  Star,  H.,  *De  morbis  infantum.  Sm.  40.  Lugd.  Bat.,  1745. 
Van  Swieten,  G.  L.  B.,  Traite  des  maladies  des  enfans,  traduit  du  latin 
des  aphorismes  de  Boerhaave,  commentes  par    .    .    .   [avec  une 
introduction]  par  M.  Paul.  160.  Avignon,  1759. 
Victorius  Faventinus,  L.  See  Faventinus,  L. 
Webel,  C.  G.  F.,  De  vi  et  auctoritate  praeceptorum  medicorum  in  educa- 

tione  Iiberorum.  8°.  [n.p.],  1778. 
Wedel,  G.  W.,  Liber  de  morbis  infantum.  40.  Jenae,  17 17. 
Whytt,  R.,  Observations  on  the  dropsy  in  the  brain.  Edinburgh,  1768. 
Wigand,  J.  H.,  Beitrage  zur  theoretischen  und  practischen  Geburt- 
shulfe  und  zur  Kenntniss  und  Kur  einiger  Kinderkrankheiten.  Hft. 
1-3,  3  vol.  8°.  Hamburg,  1 798-1808. 
Wittichius,  J.,  Libellus  de  infantilium  aegritudinum  medicatione,  das 
ist:  Artzneybuchlein,  wie  man,  den  armen  Kinderlein  fiir  allerhand 
Leibs  gebrechen,  von  Haupt  an,  bis  aufF  die  Fussole,  helffen  und 
rathen   soil.   In  richtige  Ordnung  gebracht,   und  mit   krafftigen 
wolversuchten  Mitteln  gezieret.  Sm.  40.  Leipzig,  1596. 


ADDITIONAL  PEDIATRIC  BIBLIOGRAPHY      577 

Wittich,  J.,  Ibid.  40.  Leipzig,  1607. 

Wolff,  J.  M.,  *De  causis  cur  frequentius  aegrotent  infantes  Iautioris 
quam  pauperioris  conditionis.  40.  Altorfii,  1738. 

Woyten,  J.  J.,  Physicalische  und  medicinische  Abhandlung  von  sein 
Selbst-Erkanntniss,  das  ist:  Von  der  Empfangnuss,  Bild-Nahrung 
und  Gebuhrt  derer  Menschen;  also  eingerichtet,  dass  bey  iedem 
CapituI  die  darzu  dienende  Praxis  auf  das  deutlichste  gewiesen 
wird;  it.  wie  man  mit  neugebohrnen  und  jungen  Kindern  hand- 
thieren,  umgehen,  und  selbe  vor  vielen  Kranckheiten  praeserviren 
soil;  und  endlich  eine  ausfiihrliche  Beschreibung  aller  und  jeder 
Kinder-Kranckheiten  auf  das  Klareste  gegeben,  auch,  wider  solche, 
hochstbewahrte  Artzeney-Mittel,  wie  aus  dem  Inhalte  dieses 
Werckes  zu  sehen,  samt  einem  vollkommenen  Register.  8°.  Dress- 
den,  1723. 

Wurzer,  F.,  Versuch  iiber  die  physische  Erziehung  der  Kinder.  120. 
Bonn,  1796. 

Zuckert,  J.  F.,  Von  der  diatetischen  Erziehung  der  entwohnten  und 
erwachsenen  Kinder  bis  in  ihr  mannbares  Alter.  2  Aufl.  160.  Berlin, 
1771. 


INDEX  OF  PERSONAL  NAMES 


Aaron,  in,  117 

Abt,  xii,  xix, 

Adams,  Francis,  8 

Adams,  John,  424 

Adington,  386 

Aetius,  xv,  15,  142,  226,  232,  407 

Aikin,  John,  254,  255 

Akenside,  456 

Albertus  Magnus,  72,  142 

Albinus,  401 

Alcafabrius,  62 

Alehatabrfus,  60 

Aliabas,  see  Hali  Abbas 

Alkindus,  115 

Allemann,  Albert,  vi,  137 

Ames,  142 

Andreas,  Hyacinthus,  538 

Andromachi,  53 

Andry,  400 

Anne  of  Cleves,  144 

Antyllus,  17 

Apert,  31,  33, 

Apollo,  496 

d'Arc,  Jeanne,  490 

Archer,  John,  452 

Archigenes,  9 

Aretaeus,  viii,  xvii,  4,  8,  19 

de  Argellata,  Peter,  122 

Ariosto,  490 

Aristophanes,  222 

Aristotle,  96,  97,  157,  225,  226,  227, 

229,  230,  231,  234 
Armin,  Philip,  259 
Armstrong,  xvii,  433,  441,  442,  516 
Armstrong,  John,  440 
Arnold,  Matthew,  x 
Arnold  of  Villanova,  100,  168 
Astruc,  ix 

Atkinson,  James,  442 
Atys,  233 
Aulus  gelius,  157 


228, 


Austrius,  Sebastianus,  135 

Avenzoar,  100,  109,  122,  125,  126 

Averroes,  31,  72,  75,  96,  98 

Avicenna,  viii,  xiv,  xv,  31,  37,  39,  43, 
44,  49,  50,  51,  53,  57,  59,  61,  62, 
63,  67,  72,  75,  77,  79,  83,  84,  93, 
94,  97,  98,  100,  103,  105,  106,  107, 
108,  109,  no,  112,  113,  114,  117, 
118,  119,  120,  122,  124,  126,  128, 
129,  130,  131,  132,  133,  134,  142, 
168,  192,  227,  229,  230,  231,  232, 
298,  521 

Baas,  196,  326,  466 

Bacon,  326 

Baemler,  72 

Bagellardus,    Paulus,    xvi,    27,    28,    31, 

33,  71,  100 
de   Baillou,   Guillaume,   240,   242,    243, 

326 
Baker,  298,  299 
Ballantyne,  142,  144,  145 
Ballonius,  see  de  Baillou 
Barbeirac,  Charles,  323 
Bard,  Mary,  457 
Bard,  Peter,  454 
Bard,  Samuel,  454,  456,  457,  458,  459, 

460 
Barlow,  272 

Barrington,  Lady  Anne,  333 
Barthez,  xii 
Barton,  452 
Bartsch,  ix 
Bate,  George,  259 
Bates,  256 
Bauhin,  Caspar,  viii 
Bayle,  350 

Beardsley,  Hezekiah,  432,  443 
Beddoes,  345 
Behmen,  Jacob,  xi 
Ben  Messue,  see  Mesue 


579 


580 


INDEX  OF  PERSONAL  NAMES 


Besnier,  522 

Betham,  Peter,  149 

Bichat,  410 

Bier,  xvii,  282,  349 

Billard,  xii 

Billings,  x,  259 

Blacklock,  Thomas,  514 

Blackmore,  Richard,  327,  350 

Blair,  457 

Boerhaave,  257,  321,  400,  401,  407,  424, 

459 
von  Bokay,  222 
Boleyn,  Anne,  142 
de  Boot,  Arnold,  258 
Bouchetz,  247 

Boyle,  Robert,  324,  326,  342,  343,  344 
Brady,  254 
Brettonneau,  460 
Bricheteau,  408 
Bright,  xi,  352 
Bronson,  432 
Brown,  Andrew,  322,  323 
Brown,  John,  321,  323,  382,  457 
Briining,  xv 
Brugsch,  259 
Buchan,  A.  P.,  440 
BuIIer,  A.  C,  523 
Burdach,  439 
Burnet,  353 
Burton,  John,  400,  456 
Byron,  x 

Cadogan,  William,  xvii,  382,  384,  385, 

386,  391,  395,  397,  398,  440,  519 
Cagna,  29 

Cardan,  Girolamo,  230 
Caillau,  492 
Caius,  158 

Caldwell,  Richard,  352 
Calvidius,  492 
Camac,  ix,  x 
Camper,  Peter,  384 
Carter,  William,  385 
Cartier,  Jacques,  397 
Carus,  439 
Cassandra,  xiv 
Cautley,  433 
Celsus,  Cornelius,  viii,  168,  232,  407,  456 


Charles  1,  310 

Charles  11,  310,  312,  334,  353 

Charles  vn,  490 

Charles  ix,  32 

Charlotte,  442,  449,  520 

Chereau,  ix 

Cheselden,  401 

Child,  ix 

Chrosczieyoioskii,  222 

Churchyard,  Thomas,  152 

Clarendon,  Earl  of,  522 

Cleghorn,  538 

Clossy,  457 

Cober,  Tobias,  xiv 

Coiter,  238 

Coleridge,  x 

CoIIitz,  Hermann,  vi,  469,  473 

Comrie,  ix,  x,  72,  75 

de  Corbeville,  502 

Corin,  355 

Coverdale,  147 

Coxe,  Thomas,  322 

Croesus,  233 

Cromwell,  Oliver,  285,  322 

Crookshank,  F.  G.,  240,  324 

Crusoe,  Robinson,  327 

CuIIen,  382,  424,  456 

Culpepper,  Nicholas,  259,  323 

Cumming,  457 

Cutler,  Sir  John,  256 

Cyrus,  233 

Dardanus,  157 

Daret,  240 

Davies,  Henry,  450 

Defoe,  xiv 

Demosthenes,  234 

Dent,  433 

Descartes,  404 

Despars,  Jacques,  100,  103,  105,  106, 
107,  108;  117.  118,  119,  121,  127, 
128,   129,   130,   131,   132,    133,    134 

Dibdin,  142,  143 

Diderot,  424 

Diez,  ix 

Dioscorides,  60,  62,  63,  64,  99,  170,  171* 
192,  522 

Dobson,  442 


INDEX  OF  PERSONAL  NAMES 


581 


Doras,  Comas,  492 
Dover,  Thomas,  327 
Downman,  Hugh,  514,  517 
Dryden,  151,  526 
Dubois,  Francois,  298 
Dumas,  491 
Duverney,  407 

Ebers,  viii,  xv,  259 
Eliot,  George,  384 
Elizabeth,  254,  257,  352 
Elmeston,  John,  287 
England,  Nicholas,  151 
Epictetus,  387 
d*  Estrees,  491 
Euripides,  520 
Eustachius,  384 
Evelyn,  258,  341 
Evremond,  385 

Fabricius,  Hieronymus,  372,  384 

Faire,  see  Phaer 

Fairfax,  255 

Falconer,  William,  385 

Falconier,  Peter,  454 

Farnese,  221 

Fayre,  see  Phaer 

Ferguson,  456,  457 

Fernel,  240 

Ferrers,  George,  149 

Ffaer,  see  Phaer 

Ffer,  see  Phaer 

Fidel  is,  61,  62,  64 

Fielding,  447 

Figueira,  xii 

Filatoff,  xii 

Findlay,  Leonard,  4,  259 

Finley,  Samuel,  423 

Fisher,  Charles  Perry,  28,  71 

Foote,  John,  433,  443 

Ford,  Edward,  409 

Forsyth,  xv 

Foster,  Michael,  257,  345 

Fothergill,  John,  382,  410,  454,  457 

Foucher,  Joannem,  142 

Fox,  Abraham  Lenertzon,  197 

Fracanzoni,  Antonio,  221 

France,  Anatole,  238 


Francois  1,  502 

Franklin,  Benjamin,  423,  454 

Frederick  in,  229 

Freke,  John,  447 

Freud,  404 

Froebel,  13 

Fuchs,  C.  H.,  ix,  x 

Fuller,  Thomas,  151 

Gadesden,  John,  100 

Galen,  xv,  2,  8,  15,  17,  22,  32,  37,  53, 
55,  64,  72,  83,  93,  96,  97,  99.  106, 
in,  113,  123,  126,  131,  142,  168, 
192,  225,  226,  227,  228,  229,  230, 
232,  244,  246,  298,  324,  358,  365, 
386,  407 

Garden,  Alexander,  403 

Garrison,  F.  H.,  v,  xiv,  xv,  xix,  4,  222, 
299.  300,  359,  424 

Garth,  492 

Gaucher  1,  502 

Gaucher  n,  see  Ste.-Marthe 

Gee,  259 

Gee,  Mary,  322 

Gentile,  85,  100,  106,  109,  no,  112, 
113,  114,  116,  117,  118 

George  in,  523 

Gerardus  Cremonensis,  100 

Gesner,  Conrad  (Cennad),  viii,  196,  211 

Gilbertus  Anglicus,  100 

Given,  456 

Glisson,  Francis,  xi,  xvii,  254,  255,  256, 
257,  259,  262,  266,  270,  272,  273, 
282,  325,  346,  349,  400 

Glisson,  William,  254 

Goddard,  J.,  259 

Godier,  Anne,  147 

Goncourt  (brothers),  vii 

Good,  Harry  G.,  423 

Gordon,    107,    108,    129,    131,    132,    142 

von  Gordon,  Bernard,  100 

Gotch,  342,  345 

Goulston,  255 

de  Graaf,  299 

Grandier,  Urbain,  491 

Greenhill,  W.  A.,  20,  321 

Griiling,  Philip  Gerhard,  252 

Gruner,  C.  G.,  ix 


582 


INDEX  OF  PERSONAL  NAMES 


Guidott,  Thomas,  342 
Gulfferich,  Hermann,  473 

Haeser,  x,  309,  350 

Hain,  71,  466 

Hali    Abbas    (Haliabas,    Aliabas),    37, 

55,  100,  114,  123 
Hall,  Marshall,  447,  450 
Hall,  Rowland,  151 
Haller,  257,  404 
Hamilton,  William,  384,  457 
Harris,  Walter,  xi,  xvii,  300,  301,  327, 

350,  352,  353,  354,  356,  357,  358, 

359,  360,  361,  400,  450 
Hart,  Emma,  384 
Hartog,  P.  J.,  345 
Harvey,  William,  xviii,  256,  299,  341, 

352,  404 
Havers,  324 
Hawkins,  Caesar,  447 
Heberden,  William  (father),  xii,  xvii,  382, 

386,  454,  459,  519,  520,  522.  523 
Heberden,  William  (son),    xi,  454,  519, 

523 

Heidenhain,  344 

Hennig,  xv,  222 

Henry  in,  32,  503 

Henry  iv,  240 

Henry  vin,  142,  144,  256 

Henry,  Patrick,  425 

Herbert,  143 

Herod,  395 

Herodotus,  233 

Hillary,  538 

Hippocrates,  x,  xvii,  1,  17,  19,  22,  31, 
39,  53,  84,  93,  99,  114,  128,  129, 
131,  142,  197,  221,  226,  227,  229, 
230,  242,  244,  245,  246,  248,  286, 
325,  326,  361,  362,  404,  407 

Hirsch,  370 

Hoefer,  Wolfgang,  345,  370 

Hoffmeister,  521 

von  Hohenheim,  Theophrastus  Bom- 
bast, 196 

Holmes,  Oliver  Wendell,  519 

Homer,  222 

Honain,  19,  100 

Hooke,  342,  345 


Hope,  456 

Hosack,  David,  459 

Howard,  Katherine,  144 

Huber,  71 

Huguccio,  122 

Hunter,  John,  382,  442,  454 

Huxham,  454 

Ireland,  386 

Isaac,  31,  43,  44,  5i,  67 

J-  S.,  334,  335 

Jacobi,  xv 

Jacobus,  100 

Jannensus,  120 

Jastrow,  ix 

Jeckelmann,  Madeleine,  237 

Jenkinson,  99 

Johnson,  Ben,  520,  521 

Jonas,  Richard,  98,  142,  143,   144,   14$, 

156 
Jones,  457 
Jordan,  Peter,  473 
Jourdain,  350 
Jove,  494,  496 
Julian,  12 
Justinian,  15 

Katheryne,  143,  144,  145 
Khufner,  George,  139,  140 
Kingston,  John,  151 
Kflhn,  Adam,  8,  425 
Kufneris,  Joannes,  see  Kufner 
Kyper,  299 

Lamb,  Charles,  ix 

Landau,  Richard,  71 

Lang,  J.,  371 

Latham,  321 

Laufenberg,  see  LoufFenburg 

de  Laval,  Lancelin,  492 

Lavoisier,  344 

Lee,  Sidney,  151 

Leeds,  Duke  of,  520 

Legatt,  F.,  285,  290 

Leonides,  15,  17 

Ie  Letier,  Simon,  240 

Lewis,  454 


INDEX  OF  PERSONAL  NAMES 


583 


de  Ligne,  Anne,  299 

Linacre,  256 

Lind,  272 

Lining,  John,  403 

Locke,  John,  323,  325,  326 

Loeb,  ix 

Long,  A.  H.,  vi 

Longmore,  Sir  Thomas,  309,  310 

Lortch,  260 

Loufenburg,  see  Louffenburg 

von  Louffenburg,  Heinrich,  27,  98,  465 

Louis  xiv,  285 

Lowell,  vii,  150,  344 

Lower,    Richard,    299,    343,    344,    353 

Lucian,  222 

LucuIIus,  490 

Ludwig,  410,  512 

Luisinus,  viii 

Lumley,  352 

Luther,  xi,  147 

Macaulay,  538 

Mach,  Ernst,  324 

Mackenzie,  454 

MacMichael,  520,  523 

Magati,  309 

Malet,  Claude,  29,  32,  33 

Manardus,  169 

Mancilio  Torquato,  97 

Mansi,  ix 

Maplefoot,  324 

Marguerite  of  France,  247 

Markland,  520 

Marnesz,  247 

Marsilius,  100,  154 

Martial,  222 

Martyn,  John,  355 

Mary,  149,  353 

Massa,  viii 

Matthews,  Johannes,  100 

Maximilian,  221,  229 

Mayow,  John,  xvii,  259,  268,  282,  325 

341,  342,  343,  344.  345,  346,  382 
McVickar,  John,  454,  458 
Mead,  520 
I    de'Medici,  Catharine,  32,  521 

Meissner,  Friedrich  Ludwig,  v,  xv,  285, 

556 


Meletius,  228 

Mercurialis,  Hieronymous,  221,  222,  225, 

407 
Merriman,  Samuel,  447,  450,  451 
Mery,  Francis,  144 
Mesue,  19,  31,  47,  52,  59,  61,  100,  105, 

116,  125,  131 
Methusalem,  388 
Metlinger,  Bartholomew,  xvi,  27,  71,  72, 

74,  79,  80,  83,   100,   142,   145,  473 
Michel,  439 

Middleton,  Conyers,  457,  520 
Migne,  Abbe,  ix 
Millar,  A.,  400 
Milton,  259,  323 
Mirabeau,  423 
Miron,  247 
Molins,  Edward,  310 
Monro,  Donald,  401,  408,  411,  456,  457 
Montessori,  13 
Monthenaut,  492 
Moore,  Henry,  457 
Moore,  Norman,  254,  258,  350,  355 
Morgagni,  408 
Morgan,  423 
Moschion,  15 
MuIIer,  Max,  ix 
Muffet,  Thomas,  158 
Munk,  William,  250,  254,  257,  258,  384, 

523 

Neoptolemus,  234 
Neuburger,  viii,  17 
Newton,  345 

Niccoli,  106,  107,  108,  in,  112,  113,  114, 
116,   117,   122,   123,   124,   125,   128, 

133 

Nichol,  384 

Nicolaus  Florentinus,  41,  61,  100 

Octavius,  97 

Odier,  410 

Oestereicher,  Sebastian,  135,  137 

Olivetan,  147 

Oribasius,  viii,  12,  15,  251 

Osier,  Sir  William,  xii,  8,  401,  433 

Ostwald,  ix 

Owen,  George,  152 


584 


INDEX  OF  PERSONAL  NAMES 


Paget,  N.,  259 

Paine,  424 

Paisley,  408 

Pannartz,  28 

Panzer,  466 

Papias,  122 

Paracelsus,  196,  298,  404 

Pare,  Ambroise,  4,  196,  299,  309 

Paris,  Gaston,  ix 

Parr,  Catherine,  144 

Parton,  ix 

Paul  of  Aegina,  viii,  xv,  4,  17,  32,  407 

Paulus    Aginetas,   see   Paul   of    Aegina 

Pausanius,  233 

Payne,  T.,  199,  321,  324,  325,  328,  525 

Paynell,  Thomas,  150 

Pembroke,  Earl  of,  322 

Pemell,  Robert,  xvii,  285,  286,  287,  288, 

297,  342,  391,  440 
Pepys,  Samuel,  vii,  258,  266,  323,  341, 

364 
Peresius,  Marcus,  239 
Peter  of  Abano,  100 
Peter  de  Cussiniana,  115 
Peter  Toletus,  xvi,  29 
Petit,  408 
Petronius,  222 
Pettigrew,  520 
Pfaundler,  xii 
Phaer,  Thomas,  xi,|xvi,«xvii,   146,   147, 

148,   149,   150,   I5i,|i52,   153,   154, 

155,  156,  158,  161 
Phaier,  see  Phaer 
Phauorinus,  157 
Phayer,  see  Phaer 
Phayre,  see  Phaer 
Philumenus,  15 
Phoebus,  503 
Picard,  Frederic,  321 
von  Piemont,  Franz,  100 
Pine,  R.  E.,  384 
Pits,  151 
Pius  iv,  221,  488 

Placentinus,  William,  in,  112,  123,  124 
Placidus,  Sextus,  99 
Platner,  xiv 
Plato,  157 
Platter,    Felix,   x,   xviii,   237,   238,    239 


PIatter,Thomas,  237 

Plinie,  157,  159,  174 

Plinye,  see  Plinie 

Plutarch,  4,  234 

Pluto,  495 

Polypheme,  495 

Posidonius,  226 

Pott,  Percival,  xiv,  2,  382 

Powell,  ix 

Prestwick,  341 

Pringle,  Sir  John,  403,  406 

Purfoot,  Thomas,  150 

Quillet,  Claude,  490,  491,  497,  503 
Quin,  407 
Quixote,  327,  350 

Rabelais,  32,  238,  490 

Raby  Moyses,  228 

Radcliffe,  John,  353 

Rainald,  Thomas,  see  Raynalde 

Ramsay,  Allan,  ix 

Ranza,  Giovan  Antonio,  488 

Rasis,  see  Rhazes 

Ray,  Tho.,  see  Raynalde 

Raynalde,  98,   142,   143,   144,   145,   156 

Redman,  John,  423 

Regemonter,  Ahasuerus,  259 

Renaudot,  Theophraste,  503 

Reusner,  371 

Rhazes,  x,  xv,  19,  20,  31,  37,  38,  41, 
43,  44,  50,  53,  57,  61,  62,  66,  67, 
72,  100,  106,  in,  113,  115,  117,  120, 
121,  123,  124,  127,  128,  132,  164,  168 

Rhodion,  see  Roslin 

Richardson,   Sir   Benjamin   Ward,    345 

Richelieu,  491 

Rilliet,  xii 

Robertson  (2),  457 

Roelans,  Cornelius,  xvi,  23,  27,  31,  99, 
100,  102,  103,  105,  135 

Roslin,  Eucharius,  142,  145 

Roosevelt,  384 

Roscoe,  William,  486,  488 

Rose,  Achilles,  258 

von  Rosenstein,  Nils  Rosen,  373,  450 

Rovillus,  Gulielmus,  135 

Ruffus,  226 


INDEX  OF  PERSONAL  NAMES 


585 


Rufus  of  Ephesus,  15,  99 

Rush,    Benjamin,    409,    423,    424,    425, 

426,  432,  538 
Russel,  Sol  Smith,  159 
Russell,  432 
Russill,  457 
Rutherford,  457 
de  Saint  Clair,  Audre,  see  Sinclair 

Sainte  Marthe,  492,  499,  502,  506,  5 1 1 
Saintsbury,  ix,  x 
Sangrado,  425 
Saporta,  Antoine,  238 
Saracus,  19 
Sauvages,  408,  409 
Savonarola,  142 
Scevola,  see  Ste.  Marthe 
Schacht,  Lucas,  299,  300 
Schauren,  Hans,  72 
Schenck,  497 
Schensperger,  Hansen,  72 
Schlossman,  xii 
Schott,  Johann,  135 
Schumann,  465 
Selkirk,  327 

Seller,  W.,  401,  403,  404,  406 
de  Septem  Arboribus,  Martinus,  28 
Serapio,  37,  55,  60,  61,  62,  63,  64,  134 
Serapion,  100 
Seymour,  Jane,  142 
Sharp,  Jane,  334 
Shaw,  John,  322,  342 
Sheafe,  T.,  259 
Shippen,  423,  425,  456 
Sidney,  Sir  Philip,  151 
Simmons,  M.,  288 
Simonini,  29,  31 
Sinclair,  408 
Sloane,  Hans,  327 
Slop,  456 
Smellie,  382,  456 
Smith,  454,  457 
Smith,  Daniel,  385 
Smith,  Elliot,  260 
Smith,  J.,  523 
Smith,  Richard,  309 
Soemmering,  Samuel  Thomas,  xii,  437, 
439,  520 


Solanus,  100 

Soranus,  x,  xv,  4,   15,   17,  24,  39,   158, 

247,  260 
Sourdis,  491 
Spach,  Israel,  viii 
Sparrman,  Andrew,  373 
Sprengel,  Kurt,  15 
Stahl,  345,  404 
Steiner,  Walter,  432 
Stella,  389 
Steno,  344 
Stensen,  299 
Stephen  (Mrs.),  403 
Stephen,  Leslie,  285 

Stephens,  Philemon,  285,  286,  288,  290 
Stolberg,  252 
Streater,  John,  259 
Sudhoff,  Karl,  vi,  viii,  ix,  xv,  xvi,  22, 

23,  24,  28,  31,  71,  72,  75,  99,   102, 

135,  137,  466 
Suetonius,  4 
Swammerdam,  299 
Sweynheym,  28 
Swinburne,  x 
Sydenham,  John,  322 
Sydenham,   Thomas,   xi,   xvii,    19,   238, 

242,  321,  322,  323,  324,  325,  326, 

327,  328,  350,  362,  364,  400,  425, 

454 
Sydenham,  William,  322 
Sylvius,    Franciscus,  xi,  xvii,  298,  299, 

300,  301,  302,  303,  361,  400 
Sylvius,  Jacobus,  298,  300 

Tansillo,  Luigi,  486,  488 
Tasso,  Torquato,  486 
Tennent,  Gilbert,  423,  457 
Teubner,  ix 
Thacher,  Thomas,  365 
Theophrastus,  157 
Thevart,  Jacques,  240,  242 
Thillaye,  350 
Thomson,  342 
Tiedemann,  439 
Tillotson,  353 
di  Toledo,  Garzia,  488 
Toletus,  Petrus,  31,  33 
Trench,  E.,  259 


586 


INDEX  OF  PERSONAL  NAMES 


Tristram  Shandy,  456 
Troltzki,  J.  W.,  i,  4 
Tron,  Nicolo,  31 
Twine,  Thomas,  150 
Tyndale,  147 

Uffenbach,  Peter,  viii,  222 

Underwood,  Michael,  xi,  447,  449,  450, 

539 

Unger,  Ludwig,  71,  75 

de  Valdezocchio,  Bartholomaus,  28 

Valens,  12 

Valentine,  Basil  342,  522 

Valentinian,  12 

Valerio,  97 

de  Vallembert,  Simon,  247 

Van  Helmont,  300,  404 

Van  Home,  299 

Veldener,  J.,  99 

Venus,  495 

Vesalius,  238,  298,  384 

Vettorio,  see  Victorius 

Victorius,  Leonelli  Faventide,  139,  140 

Vigfusson,  ix 

Vincenz  of  Beauvais,  467 

Virgil,  157,  222 

Vitruvius,  222 

Vulcan,  495 


Washington,  458 

Wellmann,  Max,  9 

Wenzel,  J.,  437 

Westheimer,  135 

Wharton,  256,  322 

Whistler,  Daniel,  258,  279 

Whitefield,  George,  423 

Whytt,  Robert,  v,  xi,  254,  401,  403,  404, 

405,  406,  407,  409,  4io,  457 
Wigan,  8 
William,  353,  355 
Willis,  343,  344,  400,  407 
Winslow,  401 
Wmterling,  R.  M.,  vi 
Wintringham,  386 
Wiseman,  Richard,  309,  310,  311,  312, 

313,  322,  326,  400 
Withington,  17,  19 
Wolf,  Caspar,  viii 
Wolsey,  256 

Wood,  Anthony,  322,  341,  345 
Wordsworth,  x 
Wren,  Sir  Christopher,  256 
Wright,  Herbert  F.,  vi,  22,  31,  102,  225, 

370 
Wright,  R.,  259 
Wiirtz,  Felix,  xvii,  xi,  196,  197,  199,  392 

Xenophon,  157 


Walker,  395 
Wallis,  George,  321 
Ward,  John,  403 
Warren,  449 
Waser,  John,  211 


Yeats,  345 

Young,  Sidney,  309,  457 

Yvaren,  Prosper,  242 

Zainer,  71 


INDEX  OF  SUBJECTS 


Abbildungen  und  Beschreibungen  eini- 
ger  Misgeburten,  die  sich  ehemals  auf 
dem  anatomischen  Theater  zu  Cassel 
befanden,  437 

Abdomen,  pain,  91 
worms,  91 

Account  (An)  of  the  Bilious  Remitting 
Yellow  Fever  As  It  Appeared  in  the 
City  of  Philadelphia  in  the  Year  1 793, 
426 

Acidity,  359,  533 

Adversaria  medicinalia,  242 

Ague,  190,  549 

Alkalies,  362 

Anatomia  Hepatis,  256 

Anecdotes,  384 

Angina,  Ludwig's,  512 

sufFocativa,  see  diphtheria. 

Angina  SufFocativa,  460 

Anima  (De)  Brutorum,  407 

Animal  Motions,  406 

Annalen  der  alteren  deutschen  Literatur. 
466 

Aphorisms,  2,  137 

Aphthae,  2 

Appetite,  to  recover  a  lost,  178 

Apostema  of  head,  105 

April  and  May  disease,  426 

Art  (L')Gentile  de  Peter,  513 

Arte  Gymnastica  (De),  222 

Ascarides,  378 

Astringents,  530 

Athenae  Oxoniensis,  345 

Balia  (La)  (The  Nurse),  488 

Bathing,  77,  205,  477,  507 

Bau   (Vom)   des  menschlichen  Korpers, 

437 
Bed-wetting,  61,  185 
Belly,  flux  of  the  ,180 

stopping  of,  182 


Belly,  swelling,  59 

Bier  treatment,  282 

Bleeding,  nose,  542 
private  parts,  542 

Blood-letting,  338 

Boke  of  Children,  157 

Book  the  Second  Containing  Observa- 
tions on  Several  Grievous  Diseases,  354 

Bowels,  535 

prolapse  of  large,  91 

Brain,  apostemes  of,  161 

Breast  milk,  509 

Breath,  shortness  of,  178 

Bronchocele,  371 

Brustynge,  see  hernia. 

Bubonic  plague,  xiv 

Buch  (Das)  der  Figuren,  465 

Byrth  (The)  of  Mankynde,  143 

Calculus,  2 

Callipaedia  seu  de  Pulchrae  Prolis  Haben- 

dae  Ratione,  492 
Candid  Enquiry  into  the  Merits  of  Dr. 

Cadogan's  Dissertation  on  Gout,  385 
Canker,  26,  175 
Care  of  newborn  children,  34 

prenatal,  505 
Cases  and  Observations  by  the  Medical 

Society  of  New  Haven  County,  in  the 

State  of  Connecticut,  433 
Catarrh,  47 
Certain   Symptoms  Which   Accompany 

Continued  Fevers,  325 
Chafing,  551 
Chemical     Experiments    and    Opinions 

Extracted  from  a  Work  Published  in 

the  Last  Century,  345 
Chickenpox,  521,  547 
Chilblains,  193,  552 
Children,  care  of,  199 
newborn,  75 


587 


588 


INDEX  OF  SUBJECTS 


Children,  care  of,  older,  75 

Chingles,  see  shingles. 

Cholera  infantum,  11,  426 

Chorea,  327 

Cinq  Livres  de  la  Maniere  de  Nourir  et 

Gouverner  Ies  Enfans  des  Leur  Nais- 

sance,  247 
Clothing,  216,  395,  528 
Coddes,  swelling  of,  see  orchitis. 
Cold  (in  head),  542 
Colic,  180,  302,  513 
Colike,  see  Colic. 
Commentarii  de  Morborum  Historia  et 

Curatione,  522 
Commentarius  in  Libellum  Theophrasti 

de  Vertigine,  240 
Common  Sense,  424 
Compleat  (The)  Midwife's  Companion, 

324 
Constipation,  25,  53,  91,  138 
Consumption,  194 
Continued  Fevers,  (On),  325 
Convulsionibus  (De)  Libellus,  240 
Convulsions,  2,  40,  86,  360,  540 
Cough,  47,  89,  177,  542 
Country,  recommendation  of,  516 
Cow-pox,  547 
Cramp,  167,  204 
Cravings  of  pregnant  women,  abnormal, 

506 
Cretinism,  endemic,  370 
Croup,  544 
Cyanosis  neonatorum,  34 

Declaration    of   the    Veynes  of    Man's 

Body,  147 
Definitionum  medicarum  liber,  240 
Diabetes,  140 
Diagnostick  of  the  Disorders  of  Children, 

357 
Diarrhea,  2,  25,  51,  248,  295,  361,  376, 

536 

infantile,  21 

summer,  426 
Dictionary  of  National  Biography,  345, 

350 
Diet,  137,  162,  164,  497,  526 
Digitorum  nodi,  see  fingers,  nodes,  522 


Diphtheria,  16,  335,  377,  460 

Disciples  of  Aesculapius,  345 

Discourse  at  Bathe,  342 

upon  the  Duties  of  a  Physician,  457 

Disease,  hereditary,  495 

Dissertatio  de  Basi  Encephali  et  Origin- 
ibus  Nervorum,  Cranio  Egredientium, 
437 

Dissertation  on  the  Gout,  and  all  Chronic 
Diseases,  jointly  considered,  as  pro- 
ceeding from  the  causes,  what  those 
causes  are,  and  a  rational  Method  of 
Cure  Proposed.  Addressed  to  all 
Invalids,  384 

Dissertationes  Medical  et  Chirurgicae, 

354 
Doctor  (The)  Dissected:  or  Willy  Cado- 

gan  in  the  Kitchen,  386 
Dr.    Andrew    Brown    and    Sydenham, 

323 

Dreams,  165 

Dropsy,  brain,  see  meningitis,  tubercu- 
lous. 
Dysentery,  90 
Dyspnea,  68 

Ears,  abscesses,  42 

discharge,  2 

diseases,  42,  172 

running,  87 

sore,  551 

swelling  under,  173 

tinkling  in,  173 

wind  in,  173 

worms  in,  173 
Eclampsia  ab  Hydrocephalo,  408 
Edema,  25 
Emetics,  528 

Epidemics  and  Ephemerides,  240 
Epidemiorum  et  Ephemeridum  Iibri  duo, 

240 
Epilepsy,  2,  26,  36,  39,  165,  303 
Epistaxis,  2 

Epistola  Apologetica,  300 
Epitome    of   the  Diseases   Incident  to 

Children,  523 
Eruptions,  18,  550 
Erysipelas,  93,  105,  537 


INDEX  OF  SUBJECTS 


589 


Essay  on  Mithridatum  and  Theriaca,  521 

on  the  Diseases  Most  Fatal  to  Infants, 
440 

upon  Nursing  and  the  Management  of 
Children,  384 
Eugenics,  495 
Exercise,  283 
Extracts  from   the   Diary  of  the  Late 

Michael  Underwood,  449 
Eyes,  26 

blood-shot,  169 

diseases,  41,  88 

disorders,  541 

google,  146,  194 

running,  210 

sore,  210 

watering,  169 

Farewell  (A)  to  Popery,  352 
Favosity,  37,  127 
Fear,  2,  165 
Feeding,  393 

infant,  5,  83,  509 
Felix  et  Thomas  Platter  a  Montpellier, 

237 
Fever,  69,  93,  512 

hectic,  548 

infantile,  548 

intermittent,  549 
Fingers,  contracted,  213 

nodes,  522 
Fistula,  92 
Fits,  inward,  452 
Fluor  albus,  542 
Foolishness,  370 
Forehead,  burning,  163 
Forschungen    des    19    Jahrhundert    im 

Gebiet     der     Geburtshelfe;     Frauen- 

zimmer  und  Kinderkrankheiten,  556 
Foundlings,  395 
Fractures,  218 
Full  View  of  All  the  Diseases  Incident  to 

Children,  400 
Furuncles,  92 

Gazette  de  France,  503 
General  Account  of  the  Dispensary  for 
the  Infant  Poor,  440 


Gentleman's  Magazine,  384 

Gold-Headed  Cane  (The),  523 

Gout,  389 

Grundlage  der  Literatur  der  P&diatrik, 

enthaltend    die    Monographien    iiber 

die  Kinderkrankheiten,  556 
Gums,  pain,  44 
Guttes,  rumblyng  in  the,  180 

Habits,  mental,  138 
Hare-lip,  555 
Head,  knobs  of,  164 

large,  84 
Headache,  407 
Health  Improvement,  158 
Help  for  the  Poor,  297 
Hereditary  disease,  495 
Heredity,  357 
Hernia,  62,  186 

Hiccup,  68,  90,  179,  294,  303,  337,  532 
Hicket,  see  hiccup. 
Hip,  diseased,  553 
History  of  Medicine,  350 

of  Physiology,  345 
Horae  Subsecivae,  321 
Hydrocele,  539 
Hydrocephalus,  539 

acute  internal,  406 
Hygiene,  child,  477 

prenatal,  505 

Icones  Embryonum  Humanorum,  439 

Herniarum,  437 
Incubus,  see  nightmare. 
Incunabula,  pediatric,  27 
Indigestion,  90,  533 
Indisposition,  signs  of,  530 
Infancy,  or  the  Management  of  Children : 

a  Didactic  Poem,  in  Six  Books,  514 
Infants,  care,  36 

examination  of,  357 
Influenza,  521 
Injuries,  202 
Inquiry  (An)  into  the  Cause  and  Cure  of 

the  Cholera  Infantum,  426 
Insomnia,  2,  24  (see  also  wakefulness). 
Intermittent  Fevers,  325 
Itch,  66,  170,  208 


590 


INDEX  OF  SUBJECTS 


Jaundice,  90,  531 

Joints,  stiff,  213 

Journal  bebdomodaire  de  mkdecine,  437 

Kinderkrankheiten  (Die)  nach  den 
neuesten  Ansichten  und  Erfahrungen, 
556 

King's  evil,  309,  313,  334  (see  also  scro- 
fula.) 

Kybes,  see  chilblains. 

Land  (The)  of  the  Muses,  514 

Leanesse,  194 

Lehrer  (Der)  und  der  Arzt  als  Rathgeber 

fur  Eltern  bei  Erziehung  ihrer  Kinder, 

556 
Liber  de  Passionibus  Pueronum  Galeni,  22 

de   Rheumatismo   et   Pleurilide  Dor- 
sali,  240 
Lice,  293 
Limbs,  shaking,  166 

stiffness,  168 
Lips,  fissure,  24,  45 

Lives  (The)  of  the  British  Physicians,  523 
Lyce,  see  lice. 
Lymph  nodes  in  infancy,  517 

Magnesia,  397 

Malaria,  337 

Mammary  Abscess   (On  the)   and  Sore 

Nipples  of  Lying  In  Women,  447 
Management,  526 
Marasmus,  360 
Mastoiditis,  43 

Measles,  188,  293,  329,  365,  545 
Meconium,  531 

Medical  Bibliography,  A.  B.,  442 
Memoires  of  the  Academy  of  Sciences, 

408 
Meningitis,  85 

tuberculous,  411 
Methodus      curandi      febres,      propriis 

observationibus  superstructa,  324 
Milk,  159 

test,  see  nail  test. 
Mirror  for  Magistrates,  149,  150 
Morbis  (De)  Acutis  Infantum,  354 

Aliquot  Gravioribus  Observationes, 
354 


Morbis  Capitis  (De),  286 
Puerorum  (De),  285,  290 

tractatus  Iocupletissimi,  222 
Mouth,  canker  in,  175 
Mumps,  2 

Nail  test  for  milk  (Soranus),  7,  24,  39, 

80,  247 
Navill,  swellyng  of,  183 
Neck,  swelling,  89 
Nervous,  Hypochondriacal,  or  Hysterical 

Diseases  (On),  to  which  are  prefixed 

some   remarks  on   the   Sympathy   of 

the  Nerves,  406 
Nesying,  see  sneezing. 
Newborn,  apparently  lifeless,  530 

black  color,  531 

care  of,  477,  506 
Nightmare,  68,  131,  452 
Nomothelasmus    seu     Ratio     Lactandi 

Infantes,  222 
Nose,  stopping  of,  253 
Nose-bleed,  542 
Nosologic  Methodique,  408 
Nostrils,  stricture,  48 
Numbness,  339 
Nurse,  202,  see  also  wet-nurse, 
how  to  choose,  516 

La  Balia,  488 
Nursery,  528 
Nursing,  80,  472,  505,  508,  527 

breast,  480 

horn,  445 

schedule,  509 

Observation  on  a  Dropsy  of  the  Brain, 

408 
Observations    on    the    Claims    of    the 
Moderns   to   Some   Discoveries   in 
Chemistry  and  Physiology,  345 
on  the  Dropsy  in  the  Brain,  401,  410 
on  Scrophulous  Tumours,  447 
Observationes  Medicae  Circa  Morborum 
acutorum   Historiam   et  Curationem, 

325 
Opera  Omnia,  242 
Opuscula     medica     de     arthritide,     de 

calculo  et  urinarum  hypostasi,  240 


INDEX  OF  SUBJECTS 


591 


Orchitis,  191 

Organotherapy,  39,  46,  53,  58,  62,  74, 
81,  121,  159,  174,  181,  183,  185,  190, 
191,  192,  193,  253,  294,  296,  305,  334, 

378 
Orthopedics,  212 

Palsy,  166,  339 
Paralysis,  69,  87 

infantile,  451 
Pediatrists,  medieval,  22 
Pertussis,  see  whooping  cough. 
Peste    (De)    Dissertatio,    Cui    Accessit 

Descriptio   Inoculationis   Variolarum, 

354 
Pestilence,  154 
Pharmacologia    Anti-Empirica;     or,     a 

Rational  Discource  of  Remedies,  etc., 

354 
Phthisis,  xiv 
Plaster  casts,  214 
Poems,  pediatric,  465 
Poliomyelitis,  450 
Pott's  disease,  xiv,  2 
Practica  der  Wundartzney,  196 
Precepts  of  Warre,  149 
Pregnancy,  hygiene  of,  498 
Pregnant  mother,  care  of,  473 
Prolapse  of  anus,  536 

rectum,  513 
Puericulture,  505 
Pulse,  412,  413,  419,  420 
Purgatives,  528 
Purging,  302 
Pustules,  66 
Pyssyng  in  the  bedde,  185 

Quinsy,  176 

Rachitide  (De),  256,  343,  346 

Ranula,  511 

Rectum,  prolapse,  513 

Regiment  (Ein)  der  Gesundheit  fur  die 

Jungenkinder,  473 
Regiment  of  Life,  147 
Respiration,  416 

slow,  421 
Respiratione  (De),  343 


Rickets,  5,  260,  346,  400,  511,  554 

and  other  diseases,  280 

blood  in,  267 

causes,  268 

deformities,  267 

morbid  anatomy,  260 

origin  of  name,  261 

signs  and  symptoms,  273 

treatment,  282 
Roll  of  the  Royal  College  of  Physi- 
cians, 350,  523 
Rupture,  92,  539  (see  also  hernia). 

Sacer  ignis,  see  shingles. 
St.  Vitus'  dance,  327 
Sal-Nitro  (De),  341 
Saphati,  37,  122 
Scab,  92,  170,  307 
Scald-head,  552 
Scalles,  162,  164 
Scarlet  fever,  328,  545 
Scrofula,  2,  282,  314,  552 
Scurvy,  260,  282,  307,  397 
Skin,  hardness,  537 
Skynne,  chafyng,  see  chafing. 
Sleeplessness,  164 
Small  pockes,  see  smallpox. 
Smallpox,  20,  94,  188,  190,  293,  325,  353, 
365,  373,  546 

taste  of,  376 
Sneeze-provocative,  115 
Sneezing,  68,  173,  337 
Spasms,  167 

Speculum  humanae  salvationis,  465 
Spiegel  (Der)  menschlichen  Heils,  465 
Spine,  cleft,  555 

curved,  554 

deformities,  xiv 
Spots,  purple,  550 
Squint,  88,  146,  541 
Stammering,  225 
Stenosis,  pyloric,  443 

congenital  hypertrophic,  433 
Stomach,  pain,  139 

weakness,  178 

wind,  533 
Stomatitis,  43,  89,  207 
Stone,  184 


592 


INDEX  OF  SUBJECTS 


Stone,  urine,  92 
Strabismus,  41,  417 

Straytenesse  of  wynde,  see  breath,  short- 
ness of. 
Strumas,  371 

Summer  constitution,  242 
Swaddling,  479 
Symptoms,  516 
Synoche  feaver,  337 

Tabulae  baseos  encephali,  437 
Teething,  2,  88,  137,  174,  293,  304,  482, 

512,  540 
Tenesmus,  54 
Testaceous  powders,  362 
Tetanus,  9,  133,  538 
Throat,  abscess,  46 

swelling,  176 

ulcerated,  544 
Thrush,  206,  304,  532 
Tonsillitis,  512 

Tractat  von  Kinder-Kranckheiten,  242 
Tractatus  de  scorbuto,  371 

de    ventriculo    et    intestinis,  257 

Quinque,  344 
Traffic  in  Babies,  395 
Training,  96 
Traite  de  la  conduite  des   Chirurgians, 

247 
Treatise    (A    goodly    Bryefe)    of     the 
Pestylence  with  the  causes,    signs 
and  cure  of  same,  147 

on  the  Diseases  of  Children,  449 

upon  Ulcers  of  the  Legs,  447 
Tuberculous  joints,  553 

lymph  nodes,  314 

meningitis,  406 


Two  Oxford  Physiologists,  345 
Typhus,  xiv 

Ulcer  (head),  292 
Umbilical  cord,  506 
Umbilicus,  inflammation,  2 
Upbringing  of  children,  13 
Urinating,  difficulty  in,  538 
Urine,  incontinence,  61,  538 

Veins,  155 

Venereal  disease,  549 

Venesection,  332 

Veribus  (De)  opii,  457 

Versehung  des  Leibs,  465,  467 

Virginum     (De)    et    mulierum    morbis 

liber,  240 
Virtues   of  Lime-water  in  the    Cure  of 

Stone  (On  the),  403 
Vital   and   Other   Involuntary  Motions 

of  Animals,  (On  the),  403 
Vomiting,  2,  25,  49,  178,  302,  535 

Wakefulness,  41,  86,  128,  534 

Warts,  2,  164 

Watching,  see  sleeplessness. 

Water,  difficulty  of  making,  538 

Way   (The)   to   Have   Handsome  Chil- 
dren, 492 

Weaning,  68,  83,  484 

Wet-nurse,  36,  80,  137,  484,  500,  508 

White-swelling,  553 

Whooping  cough,  244,  332,  378,  542 

Wine,  97,  138,  209,  358,  430,  497,  506 

Worms,  2,  25,  182,  295,  339,  513,  534 
abdomen,  91 

Yeaxing,  see  hicket. 


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